On World Suicide Prevention Day (10 September), it is timely to reflect upon the devastating toll that suicide and self harm take upon Aboriginal and Torres Strait Islander people, families and communities, and to examine ways to reduce this burden.
The article below has been sponsored by the Centre of Best Practice in Aboriginal & Torres Strait Islander Suicide Prevention (CBPATSISP) at the University of Western Australia, and prepared by Croakey Professional Services.
CBPATSISP aims to reduce the causes, prevalence and impact of suicide on Indigenous individuals, families and communities. It has a focus on at risk groups, and works by identifying, translating and promoting the adoption or adaption of best practice in Indigenous specific suicide prevention activity, including that which is found in emerging domestic and international research.
The Centre is also involved in organising two major events to be held in Perth in November: The Second National Aboriginal and Torres Strait Islander Suicide Prevention Conference; and the Second World Indigenous Suicide Prevention Conference. Summer May Finlay and Marie McInerney will cover these for the Croakey Conference News Service.
Government inaction a major barrier
The Federal Government’s failure to provide sustainable funding and a secure operating environment for effective programs and organisations working in Indigenous suicide prevention is a major barrier to reducing the toll of suicide.
That is according to leading experts in the field of Indigenous suicide prevention, Professor Pat Dudgeon and Professor Tom Calma AO, former co-chairs of the National Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention Advisory Group.
Dudgeon, who is from the Bardi people of the Kimberley area in WA, is a psychologist and Fellow of the Australian Psychological Society, and a researcher at the School of Indigenous Studies, University of Western Australia. Calma is an Elder from the Kungarakan tribal group and a member of the Iwaidja tribal group in the NT, Co-Chair of Reconciliation Australia, and Chancellor of the University of Canberra.
In interviews to mark World Suicide Prevention Day, Dudgeon and Calma expressed frustration with the Federal Government’s lack of long-term commitment, funding and support for Indigenous suicide prevention efforts.
Dudgeon and Calma said many pilot programs had developed strong support from communities and were producing good outcomes – but then were unable to secure ongoing funding.
In this way, the Government was contributing to a cycle of disempowerment that undermined communities’ social and emotional wellbeing, and thus increasing their risk of suicidal and self-harming behaviour, they said.
Dudgeon said: “I know of many good programs that haven’t been refunded and they’re struggling to find funding now. That is very disempowering because it doesn’t allow programs to plan into the future and also if they speak up about the system, they get penalised or punished for doing so.”
Calma said: “It is unfortunate that governments often provide funding to programs on a budgetary cycle, a Parliamentary cycle. This means they lose interest in the program, and they want to try and get something else new out of the same bucket of money to try and draw attention, if an election is coming up and so forth. They unfortunately don’t look at the big picture or respect that the community invests a lot of emotional and physical energy and time into getting up programs to have them cut.”
Dudgeon said the CBPATSISP hoped to support an analysis of which Indigenous suicide prevention programs had been defunded. The Centre also invited all Aboriginal suicide prevention programs to register with the Centre’s website, to be assessed for best practice, she said.
Calma described being promised $17.8 million by a former Labor Government some years ago to implement the inaugural 2013 Aboriginal and Torres Strait Islander Suicide Prevention Strategy.
“We still haven’t seen that money; it hasn’t been forthcoming,” he said, despite the pledges of many ministers that it would be made available. Some ministers had since asserted that these funds had been distributed across other programs, although this was not verifiable.
Calma contrasted governments’ willingness to invest in improving road safety with their lack of commitment to funding suicide prevention efforts – despite there being fewer deaths annually in road accidents than by suicide.
In 2016, there were 1,293 road fatalities compared to 2,866 people dying from intentional self-harm. Yet the Australian Government’s Black Spot funding amounts to $60 million per annum, versus $47 million per annum for suicide prevention programs.
Bureaucratic and political churn
Calma said the constant churn of Federal bureaucrats and Government ministers, and the silos within government departments also were barriers to the development and implementation of integrated programs that address social and cultural determinants that would lead to meaningful change.
The churn also put a tremendous burden on Indigenous organisations and people, who were constantly having to educate non-Indigenous Ministers and bureaucrats who were new to Indigenous affairs and often prejudiced by unconscious bias and the negative stereotypes perpetuated by much mainstream media coverage.
“It’s a real challenge because the bureaucrats are limited by and prejudiced by their own thinking,” Calma said. “You just would not believe how many bureaucrats change and this is across all departments.”
Other barriers, he said, were the lack of understanding among governments and bureaucrats of the importance of social and cultural determinants of health, and the need for holistic approaches to suicide prevention, as in Indigenous health more broadly.
“Social and emotional wellbeing is a concept that not enough bureaucrats have understood and neither have politicians,” Calma said, “although the irony is that last year, all the health ministers signed off on the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023.”
Likewise, in December last year, the Federal Cabinet agreed on the My Life My Lead report on social and cultural determinants. It is a good report, it talks about how to integrate programs support and activities. And yet that hasn’t really bitten and we are still getting each of the program areas running their own programs.
If you think that bureaucrats and senior people have difficulty coming to grips with determinants and SEWB, you can only just imagine what it’s like at community level. They have to try and navigate evolving systems and inconsistent advice. You can bet your bottom dollar that the local bureaucrats delivering the service don’t necessarily have the same understanding of the programs as those running it from Canberra or a central office.
So there’s a whole lot of disconnect as we get down through the system, and part of that is because of the ongoing churn of bureaucrats and one might say ministers and prime ministers and changing portfolios and responsibilities.
They are the sort of issues that are really contributing to the challenges that we face in Aboriginal and Torres Strait Islander affairs and they are also challenges that create despondency by recipients of services; the system’s continually changing and so they opt out of the system.
It’s too common that funding of programs is left until the end of the financial year before we know whether there is certainty of future funding, so people are leaving jobs.”
On a more positive note, Calma said it was encouraging to see that many mainstream mental health groups, such as The National Mental Health Commission, Mental Health Australia and the Black Dog Institute, were now listening to Aboriginal and Torres Strait Islander organisations and people, and privileging their expertise in documents such as the Fifth National Mental Health Plan.
Other positive developments included the Government’s investment in Aboriginal and Torres Strait Islander suicide prevention centres in Broome and Darwin, and the establishment of the Centre of Best Practice in Aboriginal & Torres Strait Islander Suicide Prevention at the Poche Centre in the University of Western Australia.
Support community-led programs
Professor Pat Dudgeon called on governments and funding agencies to support Indigenous communities to partner with researchers and universities, and to take the lead in identifying areas for research.
“The community should choose who their research partners are,” she said. “We would like to see a funding pool that communities could apply to.”
Dudgeon called on funders to support community engagement and co-design, and Indigenous-led research.
“The reality is that white people are still in charge of so much research,” she said, urging non-Indigenous people working in the Indigenous health and suicide prevention space to ensure their organisations and staff are culturally competent, and aware of how colonisation shapes health.
Dudgeon also underscored the importance of addressing the social determinants of suicide, including issues such as education, health, police, justice, poverty, racism and unemployment and cultural determinants such as languages, cultural practices, community control and respectful listening, hearing and learning. She said:
A lot of people are growing up in a society that is largely racist, and not comprehending cultural difference, so that takes its impact on you.
You live as a second-class citizen in this country. The dominant society needs to change the way they regard Aboriginal people. Stop seeing Aboriginal people as deficits, look for our strength and brilliance.”
Building cultural capacity
Building cultural capacity in the Lesbian, Gay, Bisexual, Transgender, Queer and Intersex (LGBTQI) community is vital for improving social and emotional wellbeing, according to Rebecca Johnson, a co-founder of the IndigiLez Leadership and Support Group for Aboriginal and Torres Strait Islander lesbian, same attracted and bisexual women
She is also a member of Tekwabi Giz, a national collaboration of people and organisations from Sister Girls and Brother Boys Australia, Moolagoo Mob, the gar’ban’djee’lum network, Tiwi Islands Sister Girls, IndigiLez Women, and various persons from around Australia.
Johnson, a Gooreng Gooreng woman, who is connected to the Tarlibelang Bunda people, has over 20 years experience in working in Aboriginal and Torres Strait Islander, and LGBTQI and Sister Girl and Brother Boy communities (LGBTQISB).
In an interview marking World Suicide Prevention Day, she said a gradual change is happening within the LGBTQISB sector, so that Aboriginal and Torres Strait Islander peoples’ voices are being heard in suicide prevention and postvention work.
“We wouldn’t ask a straight or heterosexual person to walk into an LGBTQI organisation and tell us how to run our affairs; it’s the same in Indigenous affairs,” Johnson said. “We would like to have cultural ownership to lead our space and to provide our cultural leadership and wisdom in the LGBTQI sector.”
Johnson said better pathways to care were needed for Indigenous LGBTQISB people that are culturally safe and informed by local communities, such as cultural healing retreats.
These retreats enable Indigenous LGBTQISB people to spend time on Country, undertaking group therapy and group activities, accessing clinical treatments, and developing relationships with Indigenous psychologists and counsellors.
IndigiLez ran Rainbow Dreaming retreats from 2008 to 2011, when they were defunded. However, the gar’ban’djee’lum network, an Indigenous LGBTQISB network, plans to roll out more such retreats in Queensland next year, after receiving funding from the National Suicide Prevention Trial.
Johnson stressed the importance of holistic approaches in suicide prevention that bring together co-design and “our connection to community, culture, land, our body and our mind”.
We have to look at the protective factors in our culture for LGBTQISB Indigenous people and how those protective factors contribute to preventing suicide and suicidality.
Many of our mob have lived experience of higher rates of isolation and discrimination in the LGBTIQ community, impacting their social and emotional wellbeing.”
Also watch this video interview, where Johnson acknowledges Kurbingui and Brisbane North Elders and gar’ban’djee’lum in the co-design of the National Suicide Prevention Trial.
Video credit: Kurbingui Youth Development, Brisbane Northside Elders, gar’ban’djee’lum network and Brisbane north PHN.
Johnson says: “Suicide is everybody’s business, including the LGBTQISB community. It’s vital that governments fund LGBTQISB Indigenous people to undertake suicide prevention and postvention work across the country.”
Remembering those who have passed
World Suicide Prevention Day is also an important opportunity to take the time to reflect upon our loved ones who have passed.
It is often said that all Aboriginal and Torres Strait Islander families have lost members and loved ones to suicide.
“This day is an opportunity to remember the good things about our lost ones,” said Calma.
“It is also an opportunity to reflect on how we can mitigate against people taking their own life or self harming, to be aware of the signs that people might be depressed or suffering in some way and to educate ourselves about the indicators, such as bullying and cyber bullying.”
“We need to reach out and let people know they are loved, and that issues are not insurmountable. Sometimes the hurt we might feel today, we won’t feel tomorrow or the next day.”
ABS figures show that in the five years from 2012 to 2016, intentional self-harm was the leading cause of death for Aboriginal and Torres Strait Islander people aged between 15 and 34, and was the second leading cause for those 35-44 years of age.
In 2016, the standardised death rate for Aboriginal and Torres Strait Islander people was 23.8 deaths per 100,000 persons, compared to 11.4 deaths per 100,000 for non-Indigenous persons. Suicide deaths also accounted for a greater proportion of all Aboriginal and Torres Strait Islander deaths (5.5 percent) compared with deaths of non-Indigenous Australians (1.7 percent).
Details of artwork in the feature image
Moortang Yoowarl Dandjoo Yaanginy
Families (Cultures) Coming Together for a Common Purpose (Sharing)
Artwork Copyright: Roma Winmar 2018
“This artwork represents our people doing business on country that is recovering from colonisation; our lands taken over, our cultures decimated, and our families separated, causing hardship, despair, and loss of hope.
• ATSISPEP resources can be downloaded here.
• Croakey’s coverage of the inaugural Aboriginal and Torres Strait Islander Suicide Prevention conference is compiled in this e-publication.
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Declaration: This article was sponsored by the Centre of Best Practice in Aboriginal & Torres Strait Islander Suicide Prevention (CBPATSISP) at the University of Western Australia, and prepared by Croakey Professional Services.