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Indigenous doctors join chorus of alarm over NT mandatory reporting laws

In this recent Crikey article, I reported that many health and medical experts are alarmed about the likely impact of  new requirements for NT health professionals to report all under-age teenage patients they suspect of being sexually active. This AAP article suggests the chorus of concern may be having some impact.

The Australian Indigenous Doctors Association has sent the letter below to all MPs in the NT.  It also mentions the impact of the NT Intervention, and deserves to be widely read by policy makers everywhere – not only in the NT.

RE: MANDATORY REPORTING REQUIREMENTS IN THE NORTHERN TERRITORY

The Australian Indigenous Doctors’ Association (AIDA) is deeply concerned about the implementation of Section 26 of the Northern Territory’s Care and Protection of Children Act 2007, in particular, its potential negative impact on Aboriginal and Torres Strait Islander young people, their families and communities.

AIDA believes that the legal obligation to report sexual activity of young people under the age of 16, irrespective of the consensual nature between same-aged peers, will disproportionately affect the Indigenous population living in the Northern Territory.  Indigenous young people are likely to engage in sexual activity at an early age(1).  Further, Indigenous females have a higher fertility rates than non-Indigenous females and are more likely to give birth during their teenage years(2).  These factors indicate that Indigenous young people will be reported for engaging in sexual activity at a higher rate than their non-Indigenous peers.

AIDA acknowledges that the purpose of this legislation is to protect young people from sexual abuse and is not racially driven.  Nonetheless, the likely consequence of mandatory reporting is that young people will avoid seeking advice from doctors and health care providers for fear of being reported for sexual activity.  This will have devastating implications for the sexual and overall health of a population already at a significant disadvantage in terms of health outcomes.  The likely impacts on health include, but are not limited to the following:

o Increased rates of STIs
o Late presentations for pregnancy and antenatal care
o Reduced opportunities to provide counselling or referrals for drug and alcohol issues
o Reduced detection of chronic diseases
o Delayed identification of mental health problems

AIDA believes that the likely surge in reporting of sexual activity of young people will have a reverberating impact on families, communities, and the health and community sector in the Northern Territory.  AIDA is concerned that there may be inadequate measures in place to support Indigenous families and communities during the process of reporting and subsequent investigation.  What assurance is the Northern Territory Government providing to families and communities that they will be supported in a culturally-sensitive and culturally-appropriate manner?

AIDA is also concerned that the mandatory reporting requirement has the potential to cause serious long-term damage to families and communities already under severe strain.  AIDA recently conducted a health impact assessment of the Northern Territory Intervention and our interim findings show that communities have suffered cultural, social and emotional harm3 as a consequence of the measures and this has led to a hardening of mistrust between communities and the Australian Government and dominant Western culture.  The issue of trauma and retraumatisation is a real concern in the context of the Northern Territory Intervention and we urge the Northern Territory Government to give this due consideration in the implementation of mandatory reporting.  We take hope from the Australian Government’s commitment to partnership and ‘resetting the relationship’ between Indigenous and non-Indigenous Australians and we hope that the Northern Territory Government will consider whether the mandatory reporting requirements will contribute towards this goal.

Against the backdrop of the Northern Territory Intervention and given the layers of trauma that exist in many Indigenous communities, it is more important than ever before that a healing approach be adopted to deal with child abuse issues.  Such an approach would build on the strength, wisdom and expertise of Aboriginal and Torres Strait Islander people and communities.  We hold serious concerns that the mandatory reporting requirement will further perpetuate a perception of all Indigenous people as abusers or victims and, like the Northern Territory Intervention, it is unclear if this will result in the successful investigations of child abuse.  In the meantime, it will be difficult to mend the breach of trust and confidentiality that has occurred in adhering to the mandatory reporting requirements.

In light of the potential harm to Indigenous health and wellbeing, we urge the Northern Territory Government to reconsider its approach to mandatory reporting and factor in the need to formally assess the impacts of this legislation through a legislative review.  Clearly, the Northern Territory Government has a duty of care to ensure that the concerns that we have raised – alongside the concerns already raised by our colleagues
in the health and medical profession – are given full and proper consideration.

Yours sincerely
Associate Professor Peter O’Mara
Acting President
Australian Indigenous Doctors’ Association

1. National Centre in HIV Epidemiology and Clinical Research. Bloodborne viral and sexually transmitted infections in
Aboriginal and Torres Strait Islander People: Surveillance Report 2007. National Centre in HIV Epidemiology and Clinical
Research, The University of New South Wales, Sydney, NSW. 2007. p 11-20

2 Australian Bureau of Statistics and Australian Institute of Health and Welfare, 2008. The Health and Welfare of
Australia’s Aboriginal and Torres Strait Islander Peoples 2008. Cat. No. 4704.0. Canberra. p 75 -98

3 AIDA submission to the NTER Review Board (2008) http://www.aida.org.au/pdf/AIDA_SubmissionNTERRB.pdf

Comments 1

  1. Jon Hunt says:

    Ethically and professionally it is nobody’s business but the patient’s and doctor’s. It is a pity that the government appears to have no understanding of why this is so, nor bothered to seek why this is so. I wonder, if these were white kids, would the same thing happen so readily?

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Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017