Rural Stigma Reduction Suicide — 07 December 2018

Deaths often driven by ‘despair caused by the history of dispossession’, report says

A Senate inquiry into mental health in rural areas found that culturally appropriate services for Aboriginal and Torres Strait Islander people are lacking.Photograph: Carly Earl for the Guardian

A Senate inquiry into mental health in rural and remote areas has found that suicide has long since reached a crisis level in Aboriginal and Torres Strait Islander communities, and “that this has been allowed to continue unchecked for so long is to Australia’s shame”.

The inquiry released its final report on Tuesday, finding that mental health services for all people in rural and remote areas were lacking, but “in too many cases, the causes of suicide for Aboriginal and Torres Strait Islander people is not mental illness, but despair caused by the history of dispossession combined with the social and economic conditions in which Aboriginal and Torres Strait Islander peoples live”.

A psychologist for the Ord Valley Aboriginal Health Service, Simon Dann, told the inquiry: “They have relatives dying consistently. We are talking about people attending a funeral every week. They are almost in a cycle of grief and loss continuously.

“We’ve got kids who probably have the same circulating stress hormones as people living in a combat zone – and that’s what they’re going back home to.”

He said many of these children, some as young as 10, “self-medicate with cannabis to deal with their stress”.

The inquiry found that Aboriginal and Torres Strait Islander people were far less likely than other Australians to access the services they need, but culturally appropriate services were hard to find.

“The committee heard overwhelming evidence that in rural and remote locations, mental health services lack the cultural competency and safety required to meet the most fundamental principle of medicine: first, do no harm,” the report said.

“In the worst cases these services traumatise and re-traumatise the very people for whom they are supposed to provide therapeutic treatment.”

The manager of the social emotional wellbeing unit of Yura Yungi Medical Service in Halls Creek, Cheryle Kaesler, told the committee that housing was a significant factor.

“There’s an extensive waiting list on the housing commission, up to four to eight years,” Kaesler said. “What we find is that this builds frustration. I honestly think it has sometimes led to suicide, because people are frustrated, they can’t get out of it and there are arguments and things like that within families.”

The committee said the lack of mental health services for Aboriginal and Torres Strait Islander communities was due in part to the “fragmentation of policy advice and funding arrangements across multiple jurisdictions”, particularly since Indigenous health funding was transferred to the Department of Prime Minister and Cabinet in 2013.

About 20% of all Aboriginal and Torres Strait Islander people live in remote or very remote areas, compared with only 1.7% of non-Indigenous Australians, and the level of psychological distress for Aboriginal and Torres Strait Islander adults is nearly three times the rate of non-Indigenous people across Australia.

“One in five Australians will experience mental illness in any year and, over a lifetime, almost half of all Australians will experience mental illness,” said Senator Rachel Siewert, the Australian Greens’ spokeswoman on mental health.

“We held 16 hearings in rural and remote areas and heard from a range of people from diverse backgrounds, including mental health consumers, farmers, miners, First Nations peoples, local councils, teachers, nurses, doctors, academics, and committed volunteers at the frontlines of suicide prevention.

“One clear message that came from these very distinct communities was that the voices and experiences of local communities are not being listened to in service design and delivery.”

The report recommends that the federal government develop a national rural and remote mental health strategy, amend funding arrangements to allow for more stability of services, and allow for more local input in designing services.

The Senate report comes in the same week that the federal health minister, Greg Hunt, called experts to a national suicide prevention summit in Canberra.

“Reducing suicide rates and improving mental health for all Australians is a key priority of this government,” he said. “Suicide is a national tragedy and one life lost to suicide is one too many.”

Hunt called for the summit after the release of figures showing that 3,128 people took their own lives in 2017, a rise of 9.1% from 2016.

The National Mental Health Commission chair, Lucy Brogden, said: “Sadly, when we talk about suicide rates we’re talking about people – people with families, friends and communities around them who are also greatly impacted.

“We will need a whole-of-government and whole-of-sector approach to tackle this problem, so this summit is a great step in the right direction.”

• Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636

This piece by Lorena Allam was first seen on ‘The Guardian‘, 5 December 2018. 

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