2018-2019...collaboration with other suicide prevention initiatives such as Live4Life, the Benalla...

Benalla Aboriginal and Torres Strait Islander Suicide Prevention Project 2018-2019

2 • Benalla Aboriginal and Torres Strait Islander Suicide Prevention Project

Acknowledgements

The Central Hume Primary Care Partnership acknowledges all Aboriginal and Torres Strait Islander peoples who contributed their time and shared their stories for this project. This project has been developed with the support of Murray PHN through the Benalla Place Based Suicide Prevention Trial including the Benalla Suicide Prevention Steering Committee and the Community Campaign Taskforce. We would also like to acknowledge the support of Benalla Rural City Council, Benalla Health, Northeast Health Wangaratta and Gateway Health Wangaratta. Finally, we would like to thank Chris Thorne, the Aboriginal Health & Community Support Worker for his knowledge, wisdom and dedication to the project. Chris brought a level of passion and emotion to the project that the whole community could empathise and relate to. Funding for this project was provided by Murray PHN

https://www.murrayphn.org.au/


Table of Contents

Acknowledgements .................................................................................. 2

Table of Contents ....................................................................................... 3

Executive Summary .................................................................................. 4

Building safety in community through suicide prevention and education .................................................................................................... 6

Mental Health First Aid: Let’s Talk Suicide Workshop and Yarning Days ................ 6

Barriers to service ...................................................................................................... 10

Benalla Suicide Prevention Community Forums ..................................................... 11

Community Connections Exhibition .......................................................................... 12

Aboriginal and Torres Strait Islander Taskforce ..................................................... 18

Live4Life ...................................................................................................................... 20

Us Mob .......................................................................................................................... 21

Benalla GP Surgeries ................................................................................................. 21

Building confidence in the mental health service pathways through

identifying current barriers to service ................................................... 23

Cultural Competency Audits ...................................................................................... 23

Benalla Communication Protocol – Suicide Postvention Plan 2019 ...................... 29

GP Service Barriers .................................................................................................... 30

Emergency Management Services ........................................................................... 31

Recommendations .................................................................................... 33

References ................................................................................................. 34

Appendices................................................................................................ 35


Executive Summary

Every day in Australia at least six Australians will die from suicide and a further 30 people will

attempt to take their own life. Indigenous Australians experience an overall rate of suicide that is

double that of non-Indigenous Australians, with young Aboriginal people being at the highest risk.1

Murray PHN have identified suicide prevention as a key priority area and are supporting targeted

suicide prevention activities within Aboriginal and Torres Strait Islander communities. Murray

PHN funded Central Hume Primary Care Partnership (auspiced by Benalla Health) to develop and

implement community based interventions and strengthening activities which support suicide

prevention through community consultation. This project aligns with the National Aboriginal and

Torres Strait Islander Suicide Prevention Strategy priority areas one and two:

1. Building strengths and capacity in Aboriginal and Torres Strait Islander communities

2. Building strengths and resilience in individuals and families

To address these two priority areas this project looks at the following two capacity building areas:

building safety in the community through suicide prevention education;

building confidence in mental health service pathway through identifying barrier to service.

Actions and resilience building activities were identified by and with the Benalla Aboriginal and

Torres Strait Islander community. These activities included yarning events, Let’s Talk Suicide:

Aboriginal and Torres Strait Islander specific mental health first aid training, a Community

Connections Exhibition, cultural knowledge sessions with a local school group called ‘Us Mob’,

collaboration with other suicide prevention initiatives such as Live4Life, the Benalla community

suicide prevention forums, and the Benalla community connect resource cards.

The project also looked at building confidence in the mental health service pathways through

improving the cultural competency of the health services both in Benalla and Wangaratta. Cultural

competency audits were completed at Benalla Health, Northeast Health Wangaratta, Gateway

Health Wangaratta. Consultations were also conducted with three GP services in Benalla to

establish any issues or barriers that they see Aboriginal and Torres Strait Islander people face

when they are accessing services. A Benalla Communications Protocol – Suicide Postvention Plan

2019 was developed to improve community capacity to minimise the risk of contagion following a

relevant suicide event.

It was identified during the yarning sessions that there is a disconnection of culture for many of the Benalla Aboriginal community members and they are unsure of where to reconnect with their

1 Black Dog Institute 2018, Facts and figures about mental health, https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=10


aunties, uncles etc. Cultural connectedness plays such an important role in building a safe community for Aboriginal and Torres Strait Islander people.

The Community Connection Exhibition has therefore played such an integral part in this project, as having an Aboriginal lead initiative has reiterated the importance of connection to community and culture, the importance of having the ability to support one another during times of need and feeling safe enough as individuals to ask for help. The Community Connections Exhibition has also started conversations about suicide prevention, not only within the Benalla LGA but surrounding LGA’s. Community feeling safe enough to have those conversations is a big step forward towards reducing stigma around mental health and suicide. The impacts of the Community Connections Exhibition will not be fully realised until the removal of the exhibition in June 2020. The information received from Murray PHN shows a significant increase in the number of people identifying as Aboriginal and/or Torres Strait Islander in Benalla general practices in the period from July 2018 to June 2019. We believe this can be attributed to the Aboriginal and Torres Strait Islander community feeling safe to identify. There has been an extreme amount of work done with health services, local police and GP services in the Benalla region to ensure that they are culturally safe.

Health services still require further assistance on how to become culturally competent. Health services need to continue to prioritise the implementation of the cultural competency strategy and ensure this continues despite changes in management and staff.

Cultural safety and responsive efforts need to be guided by Aboriginal and Torres Strait Islander professionals or Aboriginal and Torres Strait Islander people with cultural expertise. The following recommendations further support building strength and capacity of the Aboriginal and Torres Strait Islander communities and building strength and resilience in individuals and families:

Recommendation 1: Cultural healing activities to be developed for the Aboriginal Community in Benalla and surrounding areas by the local Aboriginal community.

Recommendation 2: Further Aboriginal and Torres Strait Islander specific training to run in Benalla e.g. Red Dust healing, Aboriginal and Torres Strait Islander Mental Health First Aid.

Recommendation 3: Further Aboriginal and Torres Strait Islander yarnings, gatherings and events with Benalla for the community to continue to connect with aunties, uncles, and family.

Recommendation 4: Central Hume Primary Care Partnership advocate for organisations to develop and implement their own postvention protocol.

Recommendation 5: Health services to continue to seek advice for the Aboriginal community to ensure services are delivered in a culturally safe and relevant manner with an emphasis on the importance of cultural wellbeing.

Recommendation 6: A mental health service or increased private psychologist that provides treatment and care to people of Aboriginal and Torres Strait Islander descent that is culturally safe and appropriate to their cultural and spiritual beliefs.

Recommendation 7: The Aboriginal Health & Community Support Worker to continue to work with community and the local Emergency Management Services to close the gap and rebuild trust and rapport between police and community.


Building safety in community through suicide prevention and education

Mental Health First Aid: Let’s Talk Suicide Workshop and Yarning Days

During the planning phase of the project and upon consultation with the Aboriginal community it was decide that it would be more beneficial for community to be trained in the Let’s Talk Suicide: Aboriginal and Torres Strait Islander Mental Health First Aid 5 hour Workshop than commit to the full Aboriginal and Torres Strait Islander Mental Health First Aid training. Community members felt they would struggle to commit more than one day due to work and family commitments. In order to promote the Let’s Talk Suicide: Aboriginal and Torres Strait islander Mental Health First Aid Workshop and to get the conversation started it was decided that a yarning session be held pre and post the training. The yarning sessions also allowed for open and honest conversations around the issues and barriers that Aboriginal and Torres Strait Islander people have in accessing GP’s and mental health services. Pre Workshop Yarn A pre workshop yarning flyer (refer to appendix 1) was developed and advertised at various organisations around Benalla, including the Neighbourhood House, as well as the flyer being advertised on the Benalla Place Based Trial online communication platform “Loomio” and through the Benalla Aboriginal Advisory group. There were some issues with the promotion of the pre workshop yarning event. The project team met with the local Koorie Engagement Support Officer (KESO) to see if she was able to assist with the distribution of the poster through the local ‘Us Mob’ student group at the Benalla P to 12 College. The Us Mob group consists of Aboriginal and Torres Strait Islander students from years 5 to 9. The aim was to distribute the flyer through the school every two weeks prior to the pre workshop yarning day. The KESO spoke to the school and asked the school to send out the flyer to the students every two weeks. Unfortunately, the flyers were not distributed as expected, which we believe attributed to the low attendance rate of the pre workshop yarning session. There were only three people who attended the pre workshop yarning: two community members and a member of the local police force. The extremely cold weather conditions we believe also attributed to the low attendance. However, during the first yarning session there was some important and great discussions held around the impacts of drugs and alcohol on the Aboriginal community, the impacts of intergeneration trauma, trust issues that still exist with health services, the trust issues that still exist with the police and the disconnection Aboriginal people have from their culture. It was noted that Aboriginal people who are disconnected don’t know how to reconnect with their uncles and aunties. These discussions helped to identify barriers to service for Aboriginal and Torres Strait Islander people.


Due to the low numbers of the pre workshop yarning day the Aboriginal Health & Community Support Worker and the project worker contact a number of local community members who they thought might be interested in attending. The workshop was promoted through a number of networks and with assistance from Albury Wodonga Aboriginal Health Service and the Benalla Suicide Prevention Place-based trail project. The workshop was also promoted (refer to appendix 2) to the three people who attended the pre workshop yarning event and they were asked to promote it amongst their family and friends. Let’s Talk Suicide: Aboriginal and Torres Strait Islander Mental Health First Aid Workshop The Let’s Talk Suicide: Aboriginal and Torres Strait Islander Mental Health Workshop was delivered to community by AJ Williams at the beginning of May 2019. AJ Williams, a Wiradjuri / Wotjobulak man, is the Founder and Director of Girraway Ganyi Consultancy and has an extensive list of qualifications, along with winning the 2016 Victorian Indigenous Leadership Award. The training was a huge success with 14 people taking part in the training: 11 Aboriginal community members, a member of the local police force, a carer, and the project worker. AJ Williams did a great job of facilitating and providing an understanding of suicide rates and risk factors in the Australian Indigenous context. AJ provided participants with mental health first aid guidelines on how to intervene when an Aboriginal and/or Torres Strait Islander person is experiencing suicidal thoughts and behaviours and assisted participant to practice these skills in a safe environment. In order to evaluate the training and provide a space for community to talk honestly and openly a second yarning day was held. The post workshop yarning day was held at the end of May 2019 (refer to appendix 3). Unfortunately, again we only had three people attend. There was a sense that community were keen to come to the post workshop yarning event but unfortunately due to work or personal commitments many of those who completed the training were unable to attend. The three people that did attend the post training yarning day were able to have very open and honest conversations about the training and the impact the training had on them personally. It also allowed for conversations around issues that are still impacting Aboriginal people today. To ensure we received feedback from all the training participants the Aboriginal Health & Community Support Worker and the project worker phoned each of the remaining participants for their feedback.

It was identified that there is still a lot of healing that needs to take place within community. Some of the participants of the training didn’t even realise they had unresolved trauma. The Aboriginal community within Benalla are still healing from the effects of colonisation and the stolen generation. The ongoing effects of colonisation still have a major impact on Aboriginal and Torres Strait Islanders today. The ongoing effects are commonly described as unfinished business. These effects have been recognised as significant contributors to physical illness, mental health problems and mental illness2. The Aboriginal community in Benalla needs to heal and be supported to heal through gatherings and cultural events. The Aboriginal community needs to restore and make connections. Healing is

2 Aboriginal and Torres Strait Islander Mental Health First Aid Manual, second edition. July 2016,

Mental Health First Aid Australia.


about restoring and making connections for Aboriginal and Torres Strait Islander people who have been disconnected from family, country and culture. Community were impressed with the fact that the police were invested, as a member of the local police force attended the pre workshop yarning session out of uniform, as well as the training. The feedback received from Senior Constable Gottschling regarding the training was that she has learnt about cultural specific things that need to be considered when engaging with Aboriginal and Torres Strait Islander people and that she has a better understanding of what family means to community. It was integral to the project to have the local police involved and have the local police be willing to sit down and have a chat about some of the issues facing Aboriginal people e.g. drug and alcohol, family violence, intergenerational trauma, lack of cultural connectedness. The feedback from community about the training was that the course was worthwhile and there needs to be more Aboriginal and Torres Strait Islander specific training offered. The Aboriginal and Torres Strait Islander Mental Health First Aid Manual and the Talking about Suicide, Mental Health First Aid for Aboriginal and Torres Strait Islander people Course Handbook have also been identified as highly regarded resources with many of the training participants using them within their work and sharing these resources with work colleagues. Feedback provided by participants

AJ’s approach was great, he

talked on a community

level

The workshop refreshed the tools

I already had

Shame is still so strong in

community, especially with

elders. Still things are taboo.

Opened up empathy and

understanding. Important not

to brush things off

Racism still strong

Visuals brought it home more

than talking. AJ perfect for the

job.

Would highly recommend the

training.

Learnt to be more mindful about things that are

going on around me


The Connect Benalla cards that were developed by the Community Campaign Taskforce were distributed at both yarning events and the Let’s Talk Suicide: Aboriginal and Torres Strait Islander Mental Health Workshop.

Let’s Talk Suicide: Mental Health First Aid training held on the 4th May 2019

I was able to support a suicidal friend, but

didn’t take it on myself, pushed her

supports.

Useful to know that it is important to ask the question

directly

The course was packed with really

helpful information and points out

some really important way to

approach, recognise and

speak about suicide.


Barriers to service

During the yarning events, some valuable feedback was gathered around barriers to service. Within the Benalla Aboriginal community there is still trust issues with both the police and hospital that stem back from colonisation, which is being passed down through intergenerational trauma. The Aboriginal Health & Community Support Worker will continue to work with the health services to make them more cultural safe and appropriate.

To build trust again with local police it was an important step forward to involve the police at the pre workshop yarning day and the Let’s Talk Suicide: Mental Health First Aid training. The head of the local police force and the 2IC also attended the Cultural Connections Exhibition Launch reiterating the local police’s dedication and commitment to supporting and engaging with the Aboriginal and Torres Strait Islander community. The gap between the Aboriginal community and the local police force is slowly closing. The Aboriginal Health & Community Support Worker will continue to engage and build on the relationship community has with police.

It was also identified during the yarning sessions that there is a disconnection of culture. Many of the Benalla Aboriginal community members are disconnected from culture and are unsure of where to reconnect with their aunties, uncles etc. and they look to other alternatives such as substance abuse and crime.

The Aboriginal Health & Community Support Worker understands the importance of cultural connectedness and continues to work with community to reconnect with culture. The Aboriginal Health & Community Support Worker and the Koorie Engagement Support Officer will continue their work with the ‘Us Mob” students at Benalla P to 12 College to increase their cultural knowledge and provide a cultural connection for these students and their families.

The Let’s Talk Suicide: Mental Health First Aid also provided evidence that there is a need in community for strong role models. The Aboriginal community here in Benalla still needs to heal before they are able to mentor within the community. It was established that mentoring was currently not an option, that there was a need to look at role models.


Benalla Suicide Prevention Community Forums

During August 2018, the second Benalla Suicide Prevention Community Forum was held with over 85 people in attendance. The Aboriginal Health & Community Support Worker officially opened the forum with an Acknowledgement of Country. The Acknowledgment of Country was followed by a powerful performance from Listening to Voices, an overview of the work already being done as part of the Benalla Place-based Suicide Prevention Trial, the showing of two fabulous pieces of art work, and concluded with a panel discussion. The Benalla community then had the opportunity to provide their feedback on what the priorities for suicide prevention in Benalla should be over the next three years and where the fabulous pieces of artwork should be displayed for the Benalla community to appreciate.

A third Benalla Suicide prevention Community Forum was held in February 2019. The forums continue to grow in attendance with 92 people attending. A young student performed live music as the Benalla community entered the venue, which provided a relaxed ambience. The Aboriginal Health & Community Support Worker then officially opened the third forum with an Acknowledgement of Country. The forum then lead into a very powerful and emotional story telling from parents with a lived experience. There was a lot of emotion within the room. The Benalla community could see that the community is driving the change. The Forum concluded with the launch of the Benalla Connect cards, community consultations around the development of a support group for people bereaved by suicide and the development of the 2020 Connect Benalla Calendar.

Guest speakers – Stuart and Annette Baker at the

Benalla Suicide Prevention Community Forum in

February 2019

Community Taskforce members; Paul, Wayne and Pamela


launching the Benalla Connect Resource Card

Community Connections Exhibition

The Community Connections Exhibition stemmed from the August 2018 Benalla Suicide Prevention Community Forum, where artwork designed by Aboriginal Health & Community Support Worker, in mid-2018 was first shown to the Benalla community and they were given the opportunity to decide on the best location for the paintings. The Benalla community decided the Benalla library was the prime location, as the library can be accessed by the whole community. A project proposal was developed and the Community Connections Exhibition was implemented.

The artwork visually represents the struggle and the ultimate hope that can exist within a suicidal crisis. The artwork was developed to make people think about their purpose in life.

Painting 1 - Cultural Connections Painting 2 – Life’s Purpose

The Aboriginal Health & Community Support Worker describes painting 1 - Cultural Connections, in the following way:

“I believe that so many of our mental health problems in our Aboriginal community come from the loss of connection to culture. We need our Elders to help reconnect us back to our culture, which I have tried to show in this painting through the Coolamon in the middle. The Coolamon holds our knowledge and wisdom of our culture and all the lines coming to the Coolamon are the connection to our people to bring them back to culture”.

The Aboriginal Health & Community Support Worker describes painting 2 – Life’s Purpose, in the following way:

“The colours of the hands represent all nationalities. The black person is not represented is this artwork, because they are represented in the Cultural Connection painting. What I have tried to show is that someone who doesn’t have a purpose in life can find themselves suffering with mental health issues more often than when they do have a purpose in life. Life’s purpose can be different

for everyone, but it’s important to reach to that spot to find our purpose in life.”

The Community Connections Exhibition proposal developed over a period of time with the Benalla Suicide Prevention Place Based Trial Coordinator, Central Hume PCP and the Benalla Rural City Council meeting on a number of occasions to pull together the “Community Connections” package. The package included the two pieces of artwork, training of the library staff and other customer service staff at Benalla Rural City Council, a narrative of the inception, development, launch and


outcomes of the project, an evaluation methodology for future exhibitions and a risk management plan.

It is envisioned that from the Community Connection Exhibition, the Benalla library will increase its patronage of Aboriginal and Torres Strait Islander community members into its space and will allow for quiet reflection on the topic of suicide and hopefully increase the self-help seeking behaviour of the Aboriginal and Torres Strait Islander community within Benalla.

A face-to-face meeting was conducted at the end of March 2019 between Benalla Rural City Council management, Central Hume PCP and Murray PHN to discuss progressing the exhibition. Training objectives were established during the meeting and it was acknowledged that the training would not be mandated to the staff at the library and customer service officers at Benalla Rural City Council based on the current EBA agreements. The objectives of the training included:

Increased understanding of the Benalla Place Based Trial, Increased understanding of the evidentiary link between art and increased mental health

outcomes, Increased understanding of the art work produced by the Aboriginal Health & Community

Support Worker and the link between suicide prevention, culture and purpose, Increased practical understanding of what to do to support someone who may be in

psychological distress, and Increased understanding of the Community Connections Exhibition as a whole.

The program was developed with the intention of the training being able to be delivered multiple times throughout the length of the project (12 months) and was included as part of the risk mitigation for the exhibition. The Community Connections staff training was held on the 15th May 2019 at the Benalla library. The Benalla Suicide Prevention Place Based Trial Coordinator provided the staff with an overview of the Benalla place-based suicide prevention trial and spoke about a number of interventions that have been put in place and are currently being put in place. This was followed by an emotional yarn from the Aboriginal Health & Community Support Worker around the artwork and the cultural significance between art and Aboriginal and Torres Strait Islander people. The Aboriginal Health & Community Support Worker yarned about how the designs of the artwork came to fruition and the meanings behind the artwork. It was a very heartfelt and emotional yarn with most people in the room having a tear in their eye.


Merryn Howell and Bek Nash Webster facilitating the training at the Benalla Library This provided a great segue for Merryn, a social worker and Mental Health First Aid training facilitator from Benalla Health to speak about the practical applications for responding to a vulnerable person. The social worker provided the following handouts to the library and customer service staff:

Suicidal thoughts and Behaviours – Mental Health First Aid Guidelines3 Myth buster: Suicidal Ideation4

The Benalla place based suicide prevention coordinator finished the training by providing all staff with a Connect Benalla resource card, which lists a number of support services, and reiterated that if there are any issues which arise from the Community Connect Exhibition at the library, staff can contact the Benalla place based suicide prevention coordinator at any time.

Staff were asked to fill out a form at the beginning of the training which ascertained the level of knowledge they had prior to the training and then the knowledge they had post the training and whether the training met expectations. The feedback from the staff that attending the training provided evidence that all library staff and customer service staff had gained knowledge from the training and now had a better understanding of suicide prevention. The library and customer service staff now also have resources they are able to refer to in the Benalla Connect Cards and the handouts received from the social worker. During the training a frequently asked questions sheet was constructed by the suicide prevention project support officer to assist with supporting the library and customer service staff with information regarding the Community Connections Exhibition, so that when community ask questions they will have the knowledge and resources to provide the answers. The next stage of the project was to launch the Community Connections Exhibition. The launch was promoted via a flyer (refer to appendix 4) through the Benalla Suicide prevention Steering Community and Benalla Suicide Prevention Taskforces.

3 Mental Health First Aid, revised 2014, Suicidal Thoughts & Behaviours – Mental Health First Aid Guidelines 4 Headspace, 2009, MythBuster: Suicidal Ideation


Chris Thorne, the Aboriginal Health & Community Support Worker at the

Community Connections Exhibition Launch The Aboriginal Health & Community Support Worker at the Community Connections launch explained about the artwork and how the artwork came to fruition and how we as community can stand up as individuals and do our bit to reduce the suicide rates here in Benalla. It was a very compelling and heart wrenching yarn which had the crowd captivated. Benalla Mayor Scott Upston concluded the launch with an important message to the Benalla Community about the importance of self-care. The Community Connections Exhibition was then unveiled by the Mayor and the Aboriginal Health & Community Support Worker. Over 70 people attended the launch, including an Aboriginal Elder from Mansfield, the Suicide prevention project worker from Albury Wodonga Aboriginal Health Service, a number of councillors from Benalla Rural City Council, and three members of the local police force.

Inspector Dave Ryan, Senior Constable Mark Kennedy and the Aboriginal Health & Community

Support Worker Chris Thorne at the Community Connections Exhibition launch


From the feedback received from community, the launch was a great success with some great outcomes already taking place. Outcomes from this project thus far are:

Community conversations around suicide prevention are occurring across a number of other LGA’s

The exhibition has increased the cultural visibility to community members in Benalla and is seen as a culturally safe space for Aboriginal and Torres Strait Islander people to visit whilst celebrating the connection between Aboriginal and non-Aboriginal members of the community and leading the way to reconciliation

Developed stronger working relationships with Murray PHN and the Benalla Rural City Council

Increased knowledge and distribution of the Benalla Connect Resource Cards Increased activity and support from the local Aboriginal community towards the project Increased knowledge and awareness for library staff and customer service staff at Benalla

Rural City Council via training on how to support people who maybe in distress Reducing mental health stigma and reducing racism through continual conversations

around mental health and culture.

The Community Connections Exhibition launch also received great media coverage with the Benalla Ensign posting a video at the conclusion of the launch followed by an article in the Benalla Ensign published on the 12th June 2019 (refer to appendix 5). An article was also published in the Murray PHN e-news issue # 123 on the 6th June 2019 (refer to appendix 6). Benalla Ensign Video Link - https://www.facebook.com/BenallaEnsign/videos/2332703803642612/ A clear evaluation and risk management framework was also developed as part of the Community Connections Exhibition Project. The evaluation of the project will consist of:

A tally sheet at the desk of the library and the customer service center in which library and customer service staff will be asked to note any conversations or questions that have been asked by the general population regarding the Community Connections Exhibition,

A regular stocktake of the Connect Benalla resource cards will be completed to help gain an understanding of how many cards have been taken since the launch of the Community Connections Exhibition,

Pre and post feedback will be collected during any training. Any feedback received during these training sessions will be documented,

A comments book will be located near the Community Connection Exhibition for community to provide feedback on their thoughts and feelings about the paintings (library staff will monitor the comments book on a semi-regular basis to ensure there are no inappropriate comments),

During the training of the library and customer service staff, a frequently asked questions sheet was constructed that provides possible questions and answers that the staff or community members may want to know about the paintings. The frequently asked questions sheet (refer to appendix 7) is located near the paintings and will be reviewed and updated at the bi-monthly meetings.

Face to face meetings with the manager of the library, Murray PHN and Central Hume PCP will occur every two months until June 2020 when the project is completed. All evaluation methods will be reviewed and discussed at the bi-monthly meetings.

https://www.facebook.com/BenallaEnsign/videos/2332703803642612/


Mayor, Scott Upston and the Aboriginal Health & Community Support Worker, Chris Thorne

unveiling the paintings at

the Community Connections Exhibition launch

Benalla Place Based Suicide Prevention Coordinator, Bek Nash Webster and the

Aboriginal Health & Community Support Worker, Chris Thorne at the Community Connections Exhibition launch

The project highlighted during the training the fear within the Benalla community around suicide and how to talk to a vulnerable person. Some community still believe the myth that if you talk to someone about suicide, you are planting the idea in there head. Slowly through this project and the Benalla place based suicide prevention project we are slowly removing this myth, as talking about suicide can open up the communication which is often kept a secret, and secrets that are exposed to the rational light of day often become less powerful and scary. The Community Connection Exhibition has been such an integral part of this project, as it has started conversations about suicide prevention, not only within the Benalla LGA but surrounding LGA’s. Community feeling safe enough to have those conversation is a big step forward towards reducing stigma around mental health and suicide. Having an Aboriginal led initiative has reiterated the importance of connection to community and culture, the importance of having the ability to support one another during times of need and feeling safe enough as individuals to ask for help. The impacts of the Community Connections Exhibition will not be fully realised until the removal of the exhibition in June 2020.


Aboriginal and Torres Strait Islander Taskforce

The Aboriginal and Torres Strait Islander Taskforce has been developed as part of the Benalla place based suicide prevention trial. The Aboriginal Health & Community Support Worker participates on the Aboriginal and Torres Strait Islander Taskforce. As a representative of the Aboriginal and Torres Strait Islander Taskforce, the Aboriginal Health & Community Support Worker was consulted regarding the third Benalla Community Suicide Prevention Forum that was held in February 2019. The Benalla Suicide Prevention Steering Committee really wanted to include a cultural performance within the forum. The Aboriginal Health & Community Support Worker advised that the Benalla community was not ready for a cultural performance, due to the lack of cultural education and awareness within the Benalla community and that a cultural performance may come across to community as tokenistic. The Aboriginal Health & Community Support Worker advised that there needs to be more work done with both the Aboriginal and non-Indigenous community before a cultural performance is introduced. The Community Connections Exhibition is a step in the right direction. The exhibition is increasing cultural awareness and celebrating the cultural connection for Aboriginal people and the life’s purpose connection between Aboriginal and non-Aboriginal people. Slowly as a community Benalla will be able to close the gap and lead the way to reconciliation. As a representative of the Aboriginal and Torres Strait Islander Taskforce the Aboriginal Health & Community Support Worker also provided a cultural lens for the Benalla Connect resource cards (refer to appendix 8,) which lists all the mental health services that are available to the Benalla Community, including the Aboriginal specific services. The Aboriginal specific services can be recognised by the Aboriginal and Torres Strait Islander flag icon on the cards. The Community Campaign taskforce are also in the process of developing a 2020 calendar that will provide key messages to the community. The month of July has been allocated to the Aboriginal and Torres Strait Islander community, with the theme community connections. The Aboriginal and Torres Strait Islander Taskforce is currently developing an idea for a photo for the calendar. Once the calendar reaches a first draft the Taskforce will review and ensure that the 2020 calendar in its entirety is cultural appropriate.


Community Campaign Taskforce

The Community Campaign Taskforce is another taskforce that has been developed as part of the Benalla place based suicide prevention trial. The Community Campaign Taskforce meets on a monthly basis with the goal of reducing stigma within the Benalla community, building resilience and capacity within the Benalla Community and providing the community with awareness, understanding and education around suicide prevention.

The Benalla Connect resource cards were an initiative of the Community Campaign Taskforce and were developed in conjunction with the Aboriginal and Torres Strait Islander Taskforce, who ensured culturally specific services were listed and that the resource cards were culturally appropriate.

The Community Campaign Taskforce launching the Connect Benalla resource cards at the Benalla Community Suicide prevention forum in February 2019


Live4Life

In 2017 the Benalla Rural City Council were the lead in the Live4Life Benalla Pilot Program. The Live4Life initiative aims to ensure that young people, teachers, parents and the wider community are better informed about mental ill health and are proactive in identifying the signs and symptoms of an emerging mental health issue before a crisis occurs. The Youth Live4Life initiative won the Vic Health’s Improving Mental Health Award in 2018. A partnership agreement has been developed to set out a framework for communication, information sharing and collaboration between the partner organisations so that they can effectively implement the Live4Life model. Central Hume Primary Care Partnership signed the Live4Life Partnership agreement with Benalla Rural City Council in August 2018. The Benalla Live4Life partnership meets quarterly to support the delivery of the Live4Life initiative. This includes supporting student representatives from years nine and ten (the crew) to deliver a Live4Life launch, Live4Life competition and an end of year celebration event as part of the youth leadership and participation program. In October 2018, the Live4Life celebration consisted of two events, one for each school; Benalla P to 12 College and FCJ College. The Aboriginal Health & Community Support Worker opened both celebrations with an Acknowledgement of Country. Following on from the Celebration events the Live4Life crew established that they would like to have the Aboriginal Health & Community Support Worker speak at the Live4Life launch in 2019.

At the end of February the Live4Life Partnership launch was held. The Aboriginal Health & Community Support Worker opened the formal part of the launch with an Acknowledgement of Country. Chris then had a yarn with the students about the importance of talking about their day, and how they are feeling with their mob. Chris reiterated the importance of being able to talk to your family, friends and carers and used the dinner table as a prime opportunity for this to occur. The students were fully engaged with Chris during his entire speech. As part of the Benalla Live4Life launch a video was developed, with key community members talking about young people and the impacts of mental health. The video has not yet been finalised as the video includes the Macedon Ranges and Glenelg Live4Life programs. After the launch the Aboriginal Health & Community Support Worker received exceptional feedback on how well his message had been received by the students and his speech had been highly regarded by the teachers and other service providers who attended the launch. Chris received a Certificate of Appreciation (refer to appendix 9) and a thank you card from the crew of the Live4Life project. Central Hume Primary Care Partnership will continue to contribute to the Live4Life initiative and provide cultural knowledge and expertise.


Us Mob

The Aboriginal Health & Community Support Worker and the Koorie Engagement Support Officer are currently working with students from Benalla P to 12 College in years 5 to 9 (‘Us Mob’) to provide general cultural knowledge and expertise. The “Us Mob” sessions were slow starting in 2019, as there was not a designated teacher that could assist with the running of the group. A designated teacher has now been assigned and the group continues to meet on a bi monthly basis. The “Us Mob” is a key mechanism for reconnecting students and their families with culture and connecting students and their families with local Aboriginal Aunties and Uncles. This is extremely important as it has been highlighted through the Community Connections Exhibition project that there is a disconnection to culture present in the Aboriginal community within Benalla. The Aboriginal Health & Community Support Worker will continue to work with the Koorie Engagement Support Officer to ensure the students are connected with culture.

Benalla GP Surgeries

GP’s play an important role in the Health and Wellbeing of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander people feel reluctant to navigate an “unfamiliar system” and do not want to enter a premise that might treat them in an unfriendly way or that does not feel culturally safe. Aboriginal people who have had a bad experience with health services do not complain, they just stay away. It was identified upon consultation with the three GP surgeries in town that Aboriginal and Torres Strait Islander people attended the surgeries that were flexible, affordable and provided culturally appropriate care. There has been enormous amounts of work put into educating services around being culturally safe and appropriate by the Aboriginal Health & Community Support Worker. Health services within Benalla have had culturally competent training and are asking the question “Are you Aboriginal or Torres Strait Islander?”, Aboriginal and Torres Strait Islander flags are displayed at organisations, plaques that acknowledge that the land is Aboriginal and Torres Strait Islander land are at health service entrances and there is Aboriginal artwork, flyers, and brochures on display within organisations. GP Consultations Carrier Street Surgery identified that they had 80 Aboriginal and Torres Strait Islander people who have attended the clinic in the last 12 months and 80 Aboriginal and Torres Strait Islander people in the previous 12 months. Carrier Street Surgery stated that they have lost a number of patients to the bulk billing service at Priceline. Carrier Street charge a gap fee to their patients. The bulkbilling service at Priceline identified 10 Aboriginal and Torres Strait Islander people who are currently attending their service. We believe attendance at this service will increase due to the service being the only service that publically promotes bulk billing. The last surgery to be consulted was Church Street Surgery. This GP service currently has 145 Aboriginal and Torres Strait Islanders attending their surgery with 92 being female and 53 being male. 35 of the 145 Aboriginal and Torres Strait Islanders are less than ten years old. Five years ago the GP service only had seven Aboriginal and Torres Strait Islanders attending the surgery with six of those being female and one being male. It was identified that from the 145 Aboriginal and Torres


Strait Islanders who currently attend the Church Street surgery, 18 of those people have had a mental health plan developed. The increase in patronage can be contributed to all the work the Aboriginal Health & Community Support Worker has done over the last 8 years to make the GP service culturally appropriate and safe. The Aboriginal Health & Community Support Worker has also promoted their bulkbilling services throughout community. The GP service does not promote bulk billing publically. Albury Wodonga Aboriginal Health Service has also been providing a clinical outreach service to the Benalla area via their medical van since the beginning of 2019. The medical van has been located at Waminda Neighbourhood House and is staffed with a GP and a nurse or Aboriginal Health Practitioner. Since the start of 2019 the Clinical outreach service has seen 29 Aboriginal and Torres Strait Islander people. The number of Aboriginal and Torres Strait Islander people seen by the GP in the medical van we believe can be attributed to:

the medical van being put in an area that is easily accessible by Aboriginal and Torres Strait Islander people,

the service is free. the service is culturally appropriate and safe and the service is staffed with an Aboriginal Nurse or Aboriginal Health practitioner.

The Aboriginal community within Benalla are now feeling safe to identify, as health services and outreach services in Benalla are providing a cultural safe and appropriate space for community. The information received from Murray PHN shows a significant increase in the number of people identifying as Aboriginal and Torres Strait Islander, or Aboriginal and Torres Strait Islander in Benalla general practices in the period from July 2018 to June 2019.


Building confidence in the mental health service pathways through

identifying current barriers to service

Cultural Competency Audits

In 2016 a number of health organisation undertook the Aboriginal Health Cultural Competency Framework. Upon completion of the Aboriginal Health Cultural Competence Framework audit, a number of organisations struggled to continue to implement their action plans due to the lack of resources and changes in staffing and management.

The Aboriginal Health Cultural Competence Framework was developed in 2011 to assist health services to become more culturally competent at an organisational level. The framework looked at 8 standards:

5

All health and community services need to be made accountable for the implementation of cultural competency across their organisations regardless of service size. It is important that there is accountability for these services to demonstrate an increase in their cultural competence over time.

5 Department of Rural Health 2018, Review of the Koolin Balit Aboriginal Health Cultural Competence Audit Project – Evaluation Report 2018, University of Melbourne.


The Central Hume Primary Care Partnership proposed a cultural competency audit review be completed within Benalla Health, Gateway Health Wangaratta and Northeast Health Wangaratta. The cultural competency audits were completed differently at each of the organisations due to the different levels of cultural competency across the three organisations.

Benalla Health

Benalla Health developed a Koolin Balit Aboriginal Health Cultural Competence Action Plan for 2017-2020. Due to changes within management and staffing at Benalla Health it was decided that a walkthrough of Benalla Health be undertaken to provide advice on further steps in making the health service culturally appropriate. At the end of May 2019, the Aboriginal Health & Community Support Worker for Central Hume Primary Care Partnership and the Aboriginal Health Service Development Officer for Northeast Health Wangaratta provided advice and guidance to the Director of Clinical Services and the Operational Director – Healthy Communities for Benalla Health on how to improve the cultural appropriateness and safety of Benalla Health. The audit of Benalla Health showed what work was needed in relation to the Aboriginal Health Cultural Competence Framework. Since the audit Benalla Health have promptly taken on the advice of the Aboriginal Health & Community Support Worker and the Aboriginal Health Service Development Officer for Northeast Health Wangaratta. Benalla Health have improved their cultural safety and communications through:

displaying framed posters throughout the organisation, displaying the three flags at each of the department reception areas (Aboriginal, Torres

Strait Islander, and Australian), and displaying the Koori mail etc.

Benalla Health are actively looking at their workforce development and are looking at a position for a school based apprentice in one of the areas of the hospital e.g. engineering, allied health, medical etc. Benalla Health are also looking at a traineeship within the organisation for an Aboriginal Community member who will have the opportunity to complete a qualification e.g. Diploma of Community Services. Benalla Health are committed to improving their cultural competency and have now incorporated an acknowledgement of country policy for all meetings. Benalla Health will continue to work with the Aboriginal Health & Community Support Worker to ensure that the services they provide are culturally competent and that Benalla Health are engaging with community to seek feedback about the services being delivered. Benalla Health have also committed to running cultural competency training for their staff in July 2019.


Gateway Health

Gateway Health have recognized the important of engaging and developing partnerships within the Aboriginal community throughout the region and understand the importance of reconciliation and the need to work together to close the life expectancy gap through improving the cultural, spiritual and emotional wellbeing of Aboriginal and Torres Strait Islanders. Gateway Health are advocating for Aboriginal self-determination and the provision of programs that work towards improving the health and wellbeing of Aboriginal communities. Gateway Health has begun to take steps on this journey and are committed to reconciliation. In February 2019, Gateway Health commenced with developing a Reflect Reconciliation Action Plan (RAP) and developed a working party that will provide feedback and support the RAP. The working party consisted of four non-Indigenous people and four Aboriginal people. Upon endorsement from Reconciliation Australia the RAP will be implemented at Gateway Heath by the RAP Policy Officer with input from individual Aboriginal community members, the Local Aboriginal Networks across the Ovens Murray region of Victoria and the First Nations Senior Consultative Circle. Gateway Health have already done extensive work around making their mainstream organisation a culturally safe place for the Aboriginal and Torre Strait Islander communities. The reception desk at Gateway health is visible from outside the building, there are flags on the reception desk, the staff are trained in cultural competence and are asking the question ‘Are you an Aboriginal or Torres Strait Islander?’, and lastly they employ Aboriginal staff who outreach to Wangaratta from Wodonga. Koori Room Mural Gateway Health are committed to providing the Aboriginal community with a safe space for appointments, through its Koori Room, and have provided the local Aboriginal community with a platform to celebrate their culture. The platform consisted of the wall and door outside of a Koori room, a consulting room that will be specifically used for Aboriginal clients. After consultation with the local Aboriginal and Torres Strait Islander community a mural theme was developed. The mural theme comprised of the different mobs coming together to Gateway Health for their medical treatment.

Gateway Health Mural – A place of healing


The Mural, a place for healing can be described in the following way; This mural represents Aboriginal and Torres Strait Islander People coming from all different mobs around Australia to Gateway Health to receive care and support. The central circle represents the organisation and our people surrounding it. The feet coming towards the circle are our mob coming in to receive their care. The yellow feet are our people leaving here in better health than when they arrived. The different coloured circles represent different mobs from all around Australia and the U shapes are the people within those communities. Gateway Health is a place to heal, a place to receive help and support, a place to come together.

Gateway Health continue to demonstrate their dedication to making their organisation more culturally safe and appropriate by engaging the local Aboriginal community through projects like the mural and through the implementation of the Gateway Health RAP.


Northeast Health Wangaratta

A review and walk through of Northeast Health Wangaratta took place at the end of February 2018 to establish the cultural safety and cultural appropriateness of artworks, posters and other aspects of the health service for both Aboriginal and Torres Strait Islander patients and their friends and families. Current positives and areas for future improvement were identified during the walk through. Some current positives were the acknowledgement plaques at entry points, the glass doors - being able to see into the health service before walking in, desk flags displayed, artworks displayed, Koori Mail in waiting areas, welcoming environment etc. Some future improvements included ‘asking the question’ training for triage and front reception staff, explanation of the Northeast Health Wangaratta Emergency triage process, and nurses to ask if it is okay to do vitals on men and women – respect for dignity, bedside manner.

Since the review and walk through, Northeast Health Wangaratta have updated their “identify and be deadly” signs, have updated their notice boards and pamphlet holders to include Aboriginal brochures and flyers, and community have feedback that the triage process is respectful in terms of men’s and women’s business. Northeast Health Wangaratta are now looking at spaces within the hospital that could be used for Aboriginal families and Elders to gather. There is an area outside of the palliative care rooms that could be used and would allow for smoking ceremonies to be held. There is also a possibility of having a bush tucker garden in the area that links the medical ward, the Thomas Hogan Rehabilitation ward and the Paediatric ward and also an opportunity to make the waiting room in the medical ward more inclusive.

Northeast Health Wangaratta are committed to providing a culturally competent service and will continue to engage with the Aboriginal and Torres Strait Islander service users and wider community, and continue to build their workforce development.

It was identified at the three health organisations that:

staff are requiring refresher training in asking whether patients/clients identify as Aboriginal or Torres Strait Islander,

there is a need to improve data collection on the health of Aboriginal and Torres Strait Islanders,

there is a need for further cultural competency training for staff, employment strategies need to be aimed at employing Aboriginal staff, Aboriginal staff need to be supported within their roles, Aboriginal people need to be sitting on committees with the health services, and the health services need to be supporting community events such as NAIDOC week

activities.

Health services require further assistance on how to become culturally competent. There needs to be a long term plan for implementation and review of the health services and to continue to engage leadership within organisations and create opportunities to engage staff across all levels of the organisation. Health services need to prioritise the implementation of the cultural competency strategy and prohibit de-prioritising. There is a call for accountability for these health services to demonstrate an increase in their cultural competency over time.

The Aboriginal community also has an opportunity to take leadership in ensuring that health services are culturally safe and appropriate and that health services are providing interventions that are cultural appropriate e.g. Benalla Communication Protocol. Cultural safety and responsive


efforts need to be guided by Aboriginal and Torres Strait Islander professionals or Aboriginal and Torres Strait Islander people with cultural expertise. It is also important for the health services to ensure that their governance structures support membership of and partnership with Aboriginal and Torres Strait islander communities. To close the gap there needs to be two way communication with the Aboriginal community in relation to policy development, program planning, service delivery and quality improvements.


Benalla Communication Protocol – Suicide Postvention Plan 2019

As part of the Benalla place based trial a protocol taskforce was developed. This protocol taskforce has developed a draft Benalla Communications Protocol, suicide postvention plan 2019.

From this Benalla Communication protocol a critical response team has also been developed. The critical response team will be responsible for enacting the communication protocol once a notification has been made by the local police. Five organisations have committed to being on the critical response team. Those five organisations are Albury Wodonga Health, Benalla Health, Headspace, local police and Benalla Rural City Council.

Benalla Health have taken the lead role of the critical response team and have adapted the protocol into their already existing Emergency Management System. This is the first protocol to be developed within an already existing Emergency Management System. As part of the Aboriginal and Torres Strait Islander Taskforce, the Aboriginal Health & Community Support Worker was able to review and provide feedback on the protocol to ensure that it had a culturally sensitive lens and approach. The cultural competency audit of Benalla Health has also assisted Benalla Health to take steps to become more culturally safe and appropriate. Unfortunately, there was a young person who took their life recently in Benalla. In response to the event the draft Benalla Communications Protocol was activated by the Crisis Response Team. The activation of the draft protocol provided the critical response team with some key learnings. One of those learnings was that the cultural identity of the young person was not clear in either the police or service reports. However, feedback from community was that there was a possibility that the young person was Aboriginal. Even though there was no confirmation of the young person being identified as Aboriginal, Albury Wodonga Aboriginal Health Service were alerted and notified of the event as part of the draft protocol. The draft protocol worked well in this regard. At this stage the only Aboriginal contact for the protocol is Albury Wodonga Aboriginal Health Service. The protocol taskforce are looking at connecting into community groups such as the LAN’s and the Benalla Aboriginal Advisory Group (in the case where a community member is not linked into a health service). As a result of the protocol progress the LAN’s and the Benalla Aboriginal Advisory Group will be invited to be incorporated into the community development activity of implementing their own postvention protocol. A toolkit will be developed by the Protocol Taskforce which will establish what individuals need to do in the event of a suicide. Central Hume PCP will assist with advocating for organisations to develop and implement their own postvention protocol. A new Benalla Communication protocol has also been drafted with learnings from the previous protocol upon some critical reflection on how the draft protocol was activated. The Aboriginal Health & Community Support Worker, Chris Thorne will continue to work with the Protocol Taskforce to review the progress of the Benalla Communication Protocol and the postvention protocol toolkit and ensure that it sits within best practice.


GP Service Barriers

The three GP surgeries in Benalla were consulted to establish not only how many Aboriginal and Torres Strait Islander people they have as clients/patients but also identify what they believe the barriers to be for Aboriginal and Torres Strait Islanders attending there services. Upon consultation with the three GP surgeries within Benalla there were a number of barriers that were identified. Bulk billing has been an identified issue within Benalla. Aboriginal and Torres Strait Islander people pay a gap fee when attending the Carrier Street Surgery. Church Street Surgery bulk bill Aboriginal and Torres Strait Islander people, however this is not promoted by the surgery, community promote the bulk billing service. Priceline bulk bill all their clients. It was noted that there is an access issue for mental health services. There is currently a lack of psychologists in Benalla, with a wait time of over a month to be able to get into see a psychologist. There is also a significant out of pocket cost to see a phycologist, as they do not bulk bill and a gap payment of around $80 is required. The Telehealth service with a psychiatrist is available and is bulk billed. There is a counselling service available at Benalla Health which can sometimes have extensive wait lists at different periods of time. It was also identified that the Practice Incentive program (PIP) has allowed Church Street Surgery to bulk bill Aboriginal and Torres Strait Islander clients. The Church Street Surgery commits to working towards continual improvements and quality care for Aboriginal and Torres Strait Islander people as well as improved access and health outcomes.

Currently the only clear and culturally appropriate referral pathway is to the mental health team is through Albury Wodonga Aboriginal Health Service (AWAHS). Aboriginal workers are able to refer community members to the AWAHS mental health. A visual representation of the referral pathways has not been developed due to lack of culturally appropriate mental health services. The Benalla Communications protocol highlighted this, as there was only one contact for the protocol.


Emergency Management Services

During the Let’s Talk Suicide: Mental health First Aid training, the yarning days and through the development of the draft Benalla Communications Protocol it was identified that there was a gap in the relationship of police within the Aboriginal community.

It was established that police are automatically called as part of the normal protocol when a person takes their life. It was decided that it was important to continue to work with the local police who are involved, aware and engaged and continue to build our relationship to close the gap between local Police and the Benalla Aboriginal community.

During an Aboriginal cultural event held in Wangaratta, Chris Thorne and the Central Hume Executive Officer met with representatives of VicPol from Wodonga, Wangaratta and Benalla. There is a strong commitment from the local police force to support the work being undertaken across the suicide prevention project. To ensure that there is not overburden on VicPol staff a coordinated approach between this project and the Benalla place-based trial was taken.

The local Benalla police have committed to signing the draft Benalla Communications protocol and are key in enacting the protocol.

Central Hume Primary Care Partnership met with Senior Constable Fran Gottschling on a number of occasions to discuss how the local police could engage with the Aboriginal Community more. The Aboriginal Health & Community Support Worker advised Senior Constable Gottschling that it was important to come to cultural events and gatherings when invited.

Senior Constable Gottschling attended our first yarning event as an off duty police officer in civilian clothing. The attendance of Senior Constable Gottschling was greatly appreciated by the community members at the yarning event, as being senior community members they understand the importance of police and the role they play in community.

Senior Constable Gottschling also attended the let’s Talk Suicide: Mental Health First Aid Workshop where she conveyed that she had learnt about what needs to be considered when engaging with Aboriginal and Torres Strait Islander people and now has a better understanding of what family means to community.

Inspector Dave Ryan and Senior Constable Mark Kennedy alongside a fellow officer attended the Community Connections Exhibition Launch that was held at the Benalla library. This is a great step forward for local police in building trust with the local Aboriginal community.

The Victorian State Government have been committed to improving the cultural competency of the Victorian police force by sending members of their workforce to cultural camps and introducing a Police Aboriginal Liaison Officer into their workforce. Locally police engage with members of the community and are being seen within community in a positive light. Feedback from community has also been positive and there have been lots of conversations around having police present at events.


The Central Hume Primary Care Partnership will continue to work with the local police workforce in continuing to close the gap and ensure that the Aboriginal community feel safe enough to communicate and engage with police.


Recommendations

Recommendation 1: Cultural healing activities to be developed for the Aboriginal Community in Benalla and surrounding areas by the local Aboriginal community. It is critical to recognise and nurture the connection between culture and wellbeing. It was identified in the Let’s Talk Suicide: Aboriginal and Torres Strait Islander Mental Health First Aid course that there is still a lot of healing that needs to take place within community. The training identified for some community members unresolved trauma. The Aboriginal community within Benalla are still healing from the effects of colonisation and the stolen generation. The ongoing effects of colonisation still have a major impact on Aboriginal and Torres Strait Islanders today.

Recommendation 2: Further Aboriginal and Torres Strait Islander specific training to run in Benalla e.g. Red Dust healing, Aboriginal and Torres Strait Islander Mental Health First Aid. The Benalla Aboriginal community identified the importance of Aboriginal and Torres Strait Islander specific training and that there are limited opportunities for cultural specific training within this region.

Recommendation 3: Further Aboriginal and Torres Strait Islander gathering and events with Benalla for the community to continue to connect with aunties, uncles, and family. The Cultural Connections exhibition highlighted the importance of cultural connection. There is a disconnection of culture with many Benalla Aboriginal community members and unsure of where to reconnect with their aunties, uncles etc. and they look to other alternatives such as substance abuse and crime. It is important we provide a link for community to reconnect.

Recommendation 4: C Central Hume Primary Care Partnership advocate for organisations to develop and implement their own postvention protocol.. A postvention protocol will provide organisations with a framework for mitigating negative impacts of exposure to suicide, especially for frontline workers .

Recommendation 5: Health services to continue to seek advice for the Aboriginal community to ensure services are delivered in a culturally safe and relevant manner with an emphasis on the importance of cultural wellbeing. Health Services need a long term plan for implementation and review of their health services. Health services need to prioritise the implementation of the cultural competence strategy and prohibit de-prioritising

Recommendation 6: A mental health service or increased private psychologists that provides treatment and care to people of Aboriginal and Torres Strait Islander descent that is culturally safe and appropriate to their cultural and spiritual beliefs. The Benalla Church Street Surgery identified that there is a gap in private psychologists with a current waitlist of up to a month and currently Albury Wodonga Aboriginal Health Service is the only service that is able to provide cultural appropriate mental health services.

Recommendation 7: The Aboriginal Health & Community Support Worker to continue to work with community and the local Emergency Management Services to close the gap and rebuild trust and rapport between police and community. The Aboriginal Health & Community Support Worker is seen as an Elder in the Benalla area and is key to assisting to build the trust between community and local police.


References

1. Black Dog Institute 2018, Facts and figures about mental health, https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=10

2. Mental Health First Aid, revised 2014, Suicidal Thoughts & Behaviours – Mental Health First Aid Guidelines

3. Headspace, 2009, MythBuster: Suicidal Ideation 4. Aboriginal and Torres Strait Islander Mental Health First Aid Manual, second edition. July

2016, Mental Health First Aid Australia. 5. Department of Rural Health 2018, Review of the Koolin Balit Aboriginal Health Cultural

Competence Audit Project – Evaluation Report 2018, University of Melbourne.

https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=10

https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=10


Appendices

Appendix 1


Appendix 2


Appendix 3


Appendix 4


Appendix 5


Appendix 6


Appendix 7


Appendix 8


Appendix 9

2018-2019...collaboration with other suicide prevention initiatives such as Live4Life, the Benalla...

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