Aboriginal-TorresStraitIslander
Aboriginal-TorresStraitIslander

Aboriginal and Torres Straight Islander social and emotional wellbeing

Overview

The strategic context for delivering improved Aboriginal and Torres Strait Islander social and emotional wellbeing is well-established at both a Queensland and national level. The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing emphasises the holistic and whole-of-life definition of health held by Indigenous peoples and provides a resource to support organisations delivering culturally and clinically appropriate services. Chapter seven of Planning for Wellbeing is focused in Aboriginal and Torres Strait Islander social and emotional wellbeing.

Facts and figures

30.1% of Indigenous adults report high or very high levels of psychological distress, nearly 3 times the rate reported by other Australians.

GPs report they are 2 to 3 times more likely to manage mental health problems related to substance use in Indigenous patients than in other patients.

The national suicide rate for Indigenous Australians is twice that of non-Indigenous Australians.

For Indigenous Australians between 15 and 19 years of age, the suicide rate is 5 times higher than for non- Indigenous Australians.

Indigenous people with substance use, and/or mental health disorders, require a greater number of episodes of care to effectively treat their condition.

Key documents

National cultural respect framework

National strategic framework for Aboriginal and Torres Strait Islander peoples mental health and social and emotional wellbeing

Reconciliation Action Plan - Mento North Hospital and Health Service

Reconciliation Action Plan - Brisbane North PHN

Reconciliation Action Plan - QLD Government

Objectives and actions

7.1.1

Ensure appropriate Indigenous representation on Brisbane North PHN’s partnership and governance groups.

Planned completion

Ongoing

Status

On track

7.1.2

Establish additional avenues for input to services by Indigenous consumers and carers.

Planned completion

2018/2019

Status

On track

7.1.3

Review consumer satisfaction survey processes within PHN-commissioned mental health services to make them more culturally responsive and encourage other organisations to improve the cultural responsiveness of their consumer satisfaction surveys.

Planned completion

2021/2022

Status

On track

7.2.1

Support the further development of social and emotional wellbeing teams within Aboriginal Community Controlled Health Services (ACCHSs), the HHS and NGOs.

Planned completion

Ongoing

Status

Completed

7.2.2

Require PHN-commissioned services working with Indigenous people to embed the Cultural Respect Framework and Social and Emotional Wellbeing Framework into their organisational systems and processes and encourage providers across the region to adopt these or similar approaches.

Planned completion

2019/2020

Status

On track

7.2.3

Provide cultural responsiveness training to GPs, other medical practitioners, mainstream service providers and healthcare practitioners working in forensic settings.

Planned completion

Ongoing

Status

Completed

7.2.4

Identify and promote best practice case studies of cultural responsiveness.

Planned completion

2019/2020

Status

On track

7.2.5

Continue to develop Indigenous-specific mental health, suicide prevention and alcohol and other drug care pathways in HealthPathways and ensure they are culturally responsive.

Planned completion

2020/2021

Status

On track

7.3.1

Work with relevant organisations and services to review and improve the National Disability Insurance Scheme (NDIS) processes for Indigenous people.

Planned completion

Ongoing

Status

On track

7.3.2

Explore options for making ‘soft entry’ available through a greater number of mainstream mental health services, including through use of an Indigenous worker as first point of contact for Indigenous consumers.

Planned completion

2021/2022

Status

Not started

7.3.3

Strengthen partnerships between ACCHSs and general practices offering after hours care.

Planned completion

Ongoing

Status

On track

7.3.4

Review eligibility criteria for PHN-commissioned mental health services to identify and resolve any access barriers for Indigenous people.

Planned completion

2019/2020

Status

Completed

7.4.1

Strengthen work across services and sectors and between clinical and non-clinical services, including through referral, assessment and joint case management, to ensure holistic, person-centred care that takes into account issues such as transport, housing and income.

Planned completion

2019/2020

Status

On track

7.4.2

Establish linkages between ACCHSs and mainstream mental health services, including community mental health, alcohol and other drug treatment services, primary healthcare practitioners and psychiatrists.

Planned completion

Ongoing

Status

On track

7.4.3

Increase the range of primary healthcare services readily accessible by Indigenous people by improving provider partnerships.

Planned completion

Ongoing

Status

On track

7.5.1

Review the methodology for the regional population health survey to explore opportunities for culturally responsive data collection on mental health and wellbeing of Indigenous peoples.

Planned completion

Ongoing

Status

On hold

7.5.2

Strengthen the focus on services delivered to Indigenous people by better harnessing available data on Indigenous health, including from the HHS’s integrated health information system.

Planned completion

Ongoing

Status

On track

7.5.3

Ensure investments in new or existing Indigenous mental health, social and emotional wellbeing services are appropriately evaluated and enable community-led research; use of culturally responsive measurement methods; and participatory action research methods.

Planned completion

Ongoing

Status

On track

7.6.1

Require all PHN and Queensland Health funded mental health services to demonstrate effective strategies for improving cultural responsiveness and accessibility to services by Indigenous people.

Planned completion

2019/2020

Status

Completed

7.6.2

Hold regular networking and best practice forums for Indigenous and non-Indigenous healthcare staff.

Planned completion

Ongoing

Status

Completed

7.6.3

Establish an interchange program between mainstream and Indigenous health services.

Planned completion

2020/2021

Status

On track

7.7.1

Promote implementation of appropriate organisational processes within mental health services to identify, report and act on racism and discrimination and educate consumers and staff about these processes.

Planned completion

2022/2023

Status

On track

7.7.2

Use regional publications and newsletters to educate people about the effects of racism on healthcare for Indigenous people.

Planned completion

Ongoing

Status

On track

7.8.1

Identify options for culturally responsive residential rehabilitation services for Indigenous people experiencing substance abuse and for support to successfully transition people exiting these facilities into the community.

Planned completion

2018/2019

Status

Completed

7.8.2

Explore the potential to extend existing outreach models delivered by mental health services to provide Indigenous people with support about living skills.

Planned completion

Ongoing

Status

Completed

7.8.3

Investigate options for safe places for those living with people with alcohol and other drug dependence and/or mental health issues.

Planned completion

2022/2023

Status

Not started

7.8.4

Assess national models for patient transport services and available existing local resources that assist with transport to improve access to healthcare.

Planned completion

2021/2022

Status

On track

7.8.5

Explore options for services that better respond to the needs of Indigenous children and young people experiencing mental health issues, and to their families.

Planned completion

2019/2020

Status

Completed

7.8.6

Advocate for increased funding to improve and expand safe accommodation for homeless Indigenous people living with mental health and alcohol and other drug issues.

Planned completion

2019/2020

Status

Completed

7.9.1

Some action title

Planned completion

2020

Status

On track

7.9.2

Another action

Planned completion

2022

Status

Completed

Governance

The Aboriginal and Torres Strait Islander Engagement Steering Group was established to provide the PHN with strategic guidance and local knowledge to assist with the planning, delivery and evaluation of the Aboriginal and Torres Strait Islander Engagement Project.  The Group was comprised of high-level representation from Metro North HHS, the Institute of Urban Indigenous Health, and the PHN.  The Group met regularly through 2017 and 2018 to oversee efforts to  enhance Aboriginal and Torres Strait Islander engagement, including through the implementation of the Yarn It Up engagement activities to support Planning For Wellbeing Chapter development.

The Aboriginal and Torres Strait Islander Engagement Steering Group is no longer active, following review and refinement of purpose.  The focus has now shifted to developing an updated Statement of Intent across the organisations to progress joint priorities.

Membership

Ben Thompson

General Manager for MATSICHS

Institute for Urban Indigenous Health

Paul Drahm

A/Director, Aboriginal and Torres Strait Islander Health Unit

Metro North Hospital and Health Service

Naomi Laauli

Manager, Engagement & Planning

Brisbane North PHN

Martin Milne

Executive Manager, Commissioning

Brisbane North PHN

Achievements

Planning for Wellbeing acknowledges the strong and well-established commitment to an holistic and whole-of-life focus to social and emotional wellbeing held by Aboriginal and Torres Strait Islander peoples.  This holistic perspective recognises the strength of relationships between individuals, family and community, and also the impact on the individual of connection to land, culture, spirituality and ancestry.  The shared objectives within chapter Seven of Planning for Wellbeing reflect this understanding of social and emotional wellbeing, and are focused on strategies to achieve it.

A summary of the key achievements against the eight shared objectives is included below.

Summary of Achievements

The actions to achieve this objective are focused on ensuring appropriate avenues for the Indigenous voice to actively contribute to all facets of program design and delivery.  In support of this, the PHN has actively engaged Aboriginal and Torres Strait Islander representatives to sit on a number of the partnership and stakeholder groups that supporting implementation of Planning for Wellbeing.

The actions to achieve this objective include strategies to ensure that people working with Aboriginal and Torres Strait Islander people are working in culturally responsive ways.  The broader sector has benefited from the valuable insights and guidance included within the Cultural Respect Framework 2016 – 2016 for Aboriginal and Torres Strait Islander Health [1], and the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental health and Social and Emotional Wellbeing 2017 – 2023 [2].  All Qld Health and PHN commissioned services are contractually required to ensure their practitioners are appropriately skilled and experienced, and engage in ongoing professional development regarding culturally responsive practices.

[1] Cultural Respect Framework 2016 – http://www.coaghealthcouncil.gov.au
[2] National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental health and Social and Emotional Wellbeing 2017 – 2023

The actions to achieve this objective are focused on addressing barriers to access for Indigenous people, including access to the National Disability Insurance Scheme (NDIS).  In support of addressing these barriers, the Qld Government funded the Institute for Urban Indigenous Health (IUIH) to prepare Aboriginal and Torres Strait communities in the region for the NDIS rollout.  This work included the development and implementation of readiness strategies; assisting Aboriginal and Torres Strait Islander people with a disability to apply for the NDIS; and developing a culturally appropriate service model for the provision of disability services to Aboriginal and Torres Strait Islander people.

Work in this area has focused on improving relationships between Aboriginal and Torres Strait islander services, and other mainstream services within the region, including general practice, mental health and alcohol and other drug services.  Examples of improvements in integration include:

  • Within the National Suicide Prevention Trial (NSPT) – where a large mainstream psychology practice partnered with a network of Aboriginal and Torres Strait Islander organisations to ensure culturally appropriate suicide prevention services would be provided
  • Integrated Team Care (ITC) – where IUIH provides outreach support to mainstream healthcare organisations to improve cultural responsiveness of services
  • Increasingly, other mainstream mental health and alcohol and other drug services are connecting with IUIH to establish more collaborative approaches to care.

Work in this area has included the active involvement and contribution of local Aboriginal and Torres Strait Islander organisations and community stakeholders in local and national evaluation activities.  For example, to support evaluation of the Aboriginal and Torres Strait Islander activities within the NSPT, the Commonwealth Government appointed Thirrili [1] – an Aboriginal organisation committed to addressing social disadvantage.  The PHN supported and encouraged all local Aboriginal and Torres Strait Islander organisations involved in delivering the NSPT to meet with representatives from Thirrili, to ensure their experiences and contributions were included in the evaluation.

[1] https://thirrili.com.au/

Actions to achieve these two objectives are largely being driven by the Reconciliation Action Plans of the Qld Government, the HHS and the PHN:

  • Queensland Government Reconciliation Action Plan (Stretch) – 2018 – 2021[1]
  • Metro North Hospital and Health Service Reconciliation Action Plan (Innovate) – May 2018 – May 2020 [2]
  • Brisbane North PHN Reconciliation Action Plan (Reflect) – June 2019 – June 2020 [3]

[1] https://www.datsip.qld.gov.au/resources/datsima/publications/policy/qgov-rap.pdf|
[2] https://metronorth.health.qld.gov.au/ciss/wp-content/uploads/sites/7/2018/06/reconciliation-action-plan.pdf
[3] https://www.brisbanenorthphn.org.au/page/about/our-reconciliation-action-plan/

Work in this area has focused on identifying and exploring ways to address service gaps, as well as ensuring service options better meet the needs of Indigenous people.  Within the area of suicide prevention, the PHN convened a Brisbane North Aboriginal and Torres Strait Islander Community Implementation Team to provide oversight and guidance to support effective implementation of the NSPT.  This Community Implementation Team has provided considerable insight into the needs of the Aboriginal and Torres Strait Islander communities in the region, and has lead trials of innovative activities to respond to service gaps within the region.

Success stories

Get involved

If you would like to know more about Planning for Wellbeing, or if you’re interested in getting involved, please drop us a line – we’d love to hear from you.