The perennial challenge with attending conferences is walking away knowing you have learnt something new or made a contribution that has changed the way people think, act or move forward. This week in Perth two conferences ran side by side focused on one of the big challenges of our time – the prevention of suicide. Hundreds of people from across Australia and the world gathered for the National Aboriginal and Torres Strait Island Conference on suicide prevention followed by the World Indigenous Suicide Prevention Conference. Across the planet the rates of Indigenous suicide outstrip that of non-Indigenous populations. When it comes to New Zealand it is now the highest per head of population anywhere in the world.
Both conferences had a heavy focus on the connection of language, culture and community to services designed and delivered to people. This was because of the need for many to understand that knowing where you come from and who you are is an intrinsic part of what it means to be Indigenous – knowing and speaking your language, knowing and living your culture. Importantly it is also very much about non-Indigenous people understanding the significance of culture as well as the historic challenges and barriers that have been thrown up over many years. A number of the workshops and presentations followed a natural and unique flow. Of course there were presentations that focused on things such as what the data tells us, research, evaluation and service delivery but there were also those that focused on other socio-economic factors, the age old technique of storytelling, examples of community designed, based and led initiatives and the use of culture, healing and language in the co-design of programs.
So was the conference useful in changing the way people think?
The answer is yes on two fronts. On the first front it’s not necessarily about those in the room but those out of it – politicians, policy analysts, government officials and those involved in funding or procuring programs. For them the message was clearly about the need to ensure that Indigenous people were sitting not only at the table, but involved in the design and co-design of programs that are intended for them. Right across the two conference this message was clear that often people feel excluded from the process – they feel as if something is being designed for them without their knowledge or involvement being bought to bear. In turn this often leads to dis-trust as programs are rolled out which, in turn, leads to high rates of dis-engagement. Western Australia’s Minister for Health, Roger Cook, made the point that this needed to change and we all need to focus more on Indigenous led and designed programs. I myself also made the point that was an important approach to take and many of the government officials present greed.
Image: the coming together of two cultures, Maori and Aboriginal Torres Strait Islander Photo: Dallas Gopi
That said, it’s one thing to say lets do it and a completely other thing to actually follow through. With that in mind two things need to change – firstly, the policy development process needs to be led from the ground up. This is very much the open source policy approach where you might start with what the challenge or problem followed by community engagement to crowd-source the solutions. It also means that the current structure of the plethora of committees needs to change. Currently they are set up not to serve the interests of the community but more so the interests of the service provider or agency developing an approach. The second important focus needs to be on the procurement system itself that many smaller community based organisations and movements find difficult to engage with or understand. The complexity of navigating the various systems in place such as Canada, New Zealand and Australia lead many to drop out early on or see their proposals fail because they don’t meet the “formula”. In all of these cases the reality is that on the policy design and procurement fronts Indigenous people are still being forced to engage with a system that is not “fit for purpose” because it doesn’t take into account the convergence and connection with culture and design.
Then there are the people in the room and has the conference changed their minds?
This is more complex as many people remain suspicious that one thing may be said and another done. To understand why that is the case you need to look at the history of Indigenous populations from the around the world and they have been treated over the course of the last two hundred years. That sense of disempowerment, loss and exclusion remains today which is why a high degree of trust is needed. Bridges need to be built between the two worlds and the only way that can be done is by more services providers, policy makers and decisions makers spending more time in community listening and learning instead of always talking. A number of people I talked with over the four days indicated a deep sense of validation that many of things being presented at the conference resonated with them, validated what many were doing or seeking to do and so one of the key aspects being the learning and knowledge exchange that was so clearly going on. In actual fact that last part was the most powerful – of sharing and exchanging knowledge. The outside observer could reasonably say that there are not only common threads when it comes to service delivery and design they also exist in the way that programs are implemented such as the use of storytelling techniques.
Those who were attending from a lived experience may have been a little overwhelmed at times trying to form the connection between the reality of what they have faced, and continue to face every day, and that of the need to still gather and discuss things like research, evidence based approaches and policy making. So, for them, the experience was very much about walking away with a better understanding of what all this “stuff” means at the local and community level – which begs the question “is what we talk about translatable?”.
Has a changed the way people will act?
Time can only tell as conferences normally provide a call to arms in the moment. In the case of the World Indigenous Suicide Prevention Conference a declaration was developed that has been a consistent connector between Rotorua (NZ) in 2016 and Perth (Australia) in 2018. More work is being done to try and have the declaration supported by a United Nations process but as I know from experience (Australian Representative to the UNGC 2009-2013) initiatives like this tend to get lost in the bureaucracy. Instead the suggestion needs to be that more work can be done in Individual nation states to have them adopt the declaration as part of its policy shaping moving forward. In Australia this could be championed by a dedicated National Mental Health Commissioner for Aboriginal and Torres Strait Islander peoples and in New Zealand the same position for Maori. Another thing that could be considered is for the declaration to form part of the approach we take when it comes to human rights and therefore legislation that already exists in most countries.
Image: our young people, the future leaders photo: Dallas Gopi
People will also return to their communities and act on what they have learnt. I sat with a group in Kimberly (WA, Australia) who are in the forming stages of a men’s program. Connecting them with information about a similar initiative run by Babana Aboriginal Men’s Group in Redfern (NSW, Australia) a meeting is being arranged that will see two communities at different ends of the country come together. Sharon Kenney from the Northside Aboriginal Community Group (Perth, Australia) connected with me about her work that coincided with me meeting with her State Government the following day. She has a need to expand her initiative and seek more funding to support their business plan. At the meeting with the State Government I put her organisation forward that will now result in a meeting. Two examples of immediate action stemming from the conference.
Action does require follow through on all sides and just as people involved in the conference are acting now so too must our service providers, policy makers and politicians.
Image: Traditional dance from First Nations people (Canada)
Like most conferences a series of recommendations have been made to try and break the cycle. Some of them are immediate and some of them will take time. Others kick start a conversation on where to next. The conference also had an open-source process to it where all could make a contribution. Keynote presentations generally set the scene and provided a high level view while the dozens of workshops and topic streams focused on programs and service related activities. With hundreds of people involved from a broad range of backgrounds one might think that any recommendations would be a grab bag of everything but, in fact, they were consistently clear and focused. These were some of the recommendations put forward (these are in draft form and the University of Western Australia’s Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention):
The first step in suicide prevention is a national and community level recovery and healing process for community which recognizes truth as the basis for moving forward.
Suicide prevention needs Indigenous community control, empowerment and self determination (funding must be provided to ensure this happens)
Suicide prevention needs to draw on culture to give strength and identity
Addressing racism through funded community empowerment projects is an important aspect of suicide prevention
Suicide prevention needs to the capacity and capability of Indigenous service providers
Increase the Indigenous suicide prevention workforce
Ensure the workforce is culturally safe
Embed the role of cultural healers, including paid positions
Needs based funding for Indigenous services should be mandatory and funds should be directed to Indigenous community controlled services
Recognise the important role of elders in suicide prevention and healing
Importance of investing in children and youth
Early intervention, including family support, intensive, comprehensive, wraparound services with continuity supporting agency and mastery
Young people as a valuable resource
Family center approaches not separating children from tribes
Role of young people as future leaders
Recognise the additional risk and special needs of our LGBTI + Sister Girls and Brother Boys – intersectionality of being Indigenous and LGBTIQ + SB (best informed by these communities
The importance of listening to and learning from people with a lived experience
Build local community capability to collect, analyse and use data for planning and evaluation of suicide prevention programs
Suicide mortality review data and mechanisms need to be better controlled / accessed and managed by Indigenous peoples to fully appropriate the losses and trends
Cultural values and understanding need to be represented in the type of data collected and the ways in which they are presented
National statistical agencies such as the Australian Institute for Health and Welfare to further develop the provision of community level data and to ensure community access and capacity to use data
Community level data on factors and environment influencing suicide should be used for a new approach to evaluation which is led by community rather than external agencies and used to understand and progressively improve suicide prevention programs
International collaborative, community based research and intelligence center to foster connections to first nations peoples globally
We need to address and support the mental health needs of Indigenous people engaged in the justice and corrections systems included post release
There is a need for more holistic approaches and resources to address comorbidities in Indigenous communities that may place people in vulnerable situations
Fund a national plan (Australia) for Indigenous, Aboriginal and Torres Strait Islander suicide prevention based on conference recommendations and work done by leading Indigenous advisory groups and organisations such as the Centre for Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) and in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP)
Create across country collaborative partnerships to share and learn in communities where solutions . programs are showing promising outcomes
From the elders present it was very much about using that collective knowledge and experience more often while at the same time showing respect and not just talking about it. From our young people it was very much about the desire to be engaged and be at the table when things were being developed and designed – of having a voice.
In many ways that last part “having a voice” was something that resonated across the four days. The feeling that people wanted to be heard more and in a meaningful way. The harsh reality is that we need to take a hard and cold look at ourselves about what it means to be a service provider, policy makers and decision makers. Quite clearly Indigenous people from across the world feel as if they are nothing more than a “tick the box” exercise during a process of “supposed” inclusion when things are being developed for them and not by them. Many organisations have advisory groups and committees but how meaningful are they? How impactful are they are?
At the end of the day the catch call was a simple one – we should be doing all we can to ensure that Indigenous organisations are the primary providers of services to their people, to our people.
With thanks to Professor’s Pat Dudgeon and Tom Calma, the University of Western Australia and the Centre for Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) and in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP). The many sponsors and supporters who attended the conference, the many attendees and the elders of the land on which we met.
About the author: Matthew Tukaki is the Chair of the Suicide Prevention Australia, Chair of the National Maori Authority, Ngangaru, Chair of the Auckland District of the New Zealand Maori Council and a member of the national executive of New Zealand Maori Council
Keep an eye on the conference website for updates on the draft recommendations and where from here: http://ispc2018.com/
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