An Aboriginal-led approach saved communities from Covid. Now it's time to tackle mental health

Caroline Kell for IndigenousX

Indigenous-run health organisations can use their successful approach to coronavirus safety to transform the mental health system

The Australian Aboriginal flag
‘Five Aboriginal-led solutions are put forward in this [Balit Durn Durn] report that will dramatically transform the Victorian mental health system to better meet the needs of Aboriginal communities.’ Photograph: Lukas Coch/AAP
‘Five Aboriginal-led solutions are put forward in this [Balit Durn Durn] report that will dramatically transform the Victorian mental health system to better meet the needs of Aboriginal communities.’ Photograph: Lukas Coch/AAP

Last modified on Wed 18 Nov 2020 22.04 EST

I took part in a workshop recently where we were asked to describe an Aboriginal community controlled health organisation.

The answers from participants were revealing in that they did not mention GPs, nurses or community health programs. Instead they described a state of feeling: “a hug from an aunty or uncle”, a place “where you’re safe to just be”, “a place free from racism and prejudice”, a “connectedness”.

It is those underlying feelings, I believe – the feelings of connectivity, trust and safety – that kept our communities safe during the Covid-19 crisis response.

There are 58,000 Aboriginal and Torres Strait Islanders in Victoria. This population is predicted to grow to 82,000 by 2030.

We saw six positive cases over the first few months of the pandemic and that rose to 74 cases during the second wave.

If we had seen a major outbreak or cluster, the outcomes would have been catastrophic.

Due to the government’s many failed attempts at closing the gap, our communities live with higher rates of the kind of pre-existing medical conditions that make us more vulnerable to coronavirus: heart and lung disease, diabetes and compromised immune systems.

In early March, when the pandemic hit, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) did not want to take any chances.

We assembled our 32 Aboriginal organisations and met fortnightly with the state and federal governments, an arrangement that is still in place today.

We made sure we had the latest public health information, the latest data, that we could disseminate in our way. In our cultural shape. In ways our people would understand.

All 32 organisations continue to work tirelessly to keep our families and communities safe. There is no doubt this community-based health response stopped outbreaks and saved lives.

Many of our organisations transformed their workforces in a matter of days, moving to online arrangements to manage clients and staff.

Twenty-four of them provide Covid-19 testing supports.

The Victorian Aboriginal Health Service, an almost 50-year-old institution in the heart of Fitzroy, knew early on that social isolation would be a major issue, so it developed its own crisis line. Yarning Safe’n’Strong is a free and confidential phone crisis line. It is available 24 hours, seven days a week on 1800 959 563.

Many ACCOs continue to go above the call of duty – they work after hours to service families and communities, often unfunded.

One major challenge we will face in the weeks, months and years ahead is mental health and Aboriginal social and emotional wellbeing.

In February, pre-Covid, we were a few days away from running a series of consultations with Aboriginal people across the state to support the royal commission into Victoria’s mental health system.

VACCHO’s mandate: talk to as many Aboriginal and Torres Strait Islander people as we could about ways to improve Victoria’s mental health system and develop a report to be tabled in parliament in early 2021.

It was our opportunity to finally be heard and overhaul a system that did not capture or support our needs.

The stats are grim. We know we are three times more likely than non-Aboriginal people to experience high or very high levels of psychological distress.

We know Aboriginal suicides are closely linked to mental health issues, with about 80% of deaths linked to a diagnosed and/or suspected mental illness.

We know that Aboriginal people are four times more likely to present to hospital for mental health-related emergencies.

We know there is a strong link between trauma and poor mental health.

We knew we could not let this opportunity slip.

We drew from hearings and submissions completed by Aboriginal leaders and experts in social and emotional wellbeing. We built on years of advocacy from Aboriginal organisations, leaders and those delivering frontline services. We spoke to Aboriginal people with lived mental health experience, workers and experts with extensive knowledge in the mental health field.

The result is Balit Durn Durn, a groundbreaking report. Balit Durn Durn comes from the Wurundjeri/Woiwurrung language and means “strong brain, mind, intellect and sense of self”.

What do you think people told us when we asked them how they wanted to improve their mental health? To no surprise almost all participants talked about the need to ensure Aboriginal culture is embedded into treatment alongside Western models of treatment – paid aunty and uncle roles, healing centres, camps and mandating the Aboriginal social and emotional wellbeing wheel across mainstream providers.

Many spoke about the need to critically invest in suicide post-vention and prevention. And the need to do it now before we lose any more of our people.

Many spoke about making sure that Aboriginal workers were not just servicing the frontline but had pipelines to leadership, to make and influence decisions that impact their people.

Five Aboriginal-led solutions are put forward in this report that will dramatically transform the Victorian mental health system to better meet the needs of Aboriginal communities.

We ask that non-Aboriginal people walk alongside us in the march to improve Aboriginal health and wellbeing post-Covid. We ask that you help us spread the word by using #BalitDurnDurn and by taking a selfie with your message, tweeting your support and liking VACCHO’s Facebook page.

  • Caroline Kell has held senior Aboriginal affairs positions in the Victorian state government. In February she joined the Victorian Aboriginal Community Controlled Health Organisation as executive director of policy, advocacy, research and communications.