Children on care and protection orders |
Repeat offending |
Access to primary health care |
Mental health |
Proportion of Indigenous people with access to their traditional lands |
Participation in organised sport, arts or community group activities |
Engagement with service delivery
Families and communities are the mainstay of our society. The extent to which they are functional and resilient influences a range of outcomes for Indigenous people. A caring, protective and supportive environment, together with positive health outcomes and cultural awareness, are particularly important.
Dysfunctional families and communities can lead to breakdown in relationships and social alienation, and contribute to physical and mental health problems. Ultimately, life expectancy, education, imprisonment, violence, employment and income can be affected.
THINGS THAT WORK
The Lake Tyers Community Renewal Project is a partnership in progress between the Lake Tyers Aboriginal community and the Victorian Government. Strategies under the Renewal Project have improved community infrastructure, and created opportunities for positive community engagement (box 9.1).
Children on care and protection orders
Data on children under care and protection orders show the extent to which some form of legal intervention has been made for their protection.
Not all orders are due to neglect and abuse - in some cases, family difficulties such as a parent being hospitalised or dying may be the reason why a child is placed in care. However, legal intervention is usually a last resort, after other interventions have not been possible or have failed, and these data may provide some indication of the social and cultural stress under which many people in Indigenous communities live.
KEY MESSAGES
Almost 30 out of every 1000 Indigenous children aged 0–17 years were on care and protection orders at 30 June 2006 , compared to 5 per 1000 for non-Indigenous children (table 9.1.2).
From 1999-2000 to 2005-06, the rate of children on care and protection orders increased for both Indigenous and non-Indigenous children in all states and territories (table 9A.1.1).
Repeat offending
Cycles of intergenerational offending, where children of prisoners commit offences that result in their own imprisonment, is common for Indigenous families. This cycle of Indigenous imprisonment has severe effects on families and communities. It is important that people who have contact with the criminal justice system have the opportunity to integrate back into the community, lead productive lives, and not re-offend.
KEY MESSAGES
In 2006, a greater proportion of Indigenous prisoners (74 per cent) than non-Indigenous prisoners (52 per cent) had prior adult imprisonment (figure 9.2.1).
From 2000 to 2006, there was no significant change at the national level in the proportion of Indigenous prisoners with prior adult imprisonment (table 9A.2.3).
In studies on juvenile offenders carried out in NSW, Queensland, WA and SA, Indigenous juveniles experienced a higher number of court reappearances and higher rates of repeat offending than non-Indigenous juveniles (table 9A.2.6 and figures 9.2.4, 9.2.6 and 9.2.7).
THINGS THAT WORK
Since February 2002, Circle Sentencing in Nowra, NSW, has provided an alternative sentencing court for adult Indigenous offenders. It has reduced re-offending among Indigenous offenders and contributed to the Indigenous community. Circle Sentencing Courts have since been established in eight other locations in NSW (box 9.2.2).
The Rumbalara Women’s Mentoring Program was established in Victoria in 2002 to reduce reoffending among Indigenous women. Following the success of the Rumbalara pilot, the mentoring program has been expanded to five locations for both Indigenous men and women (box 9.2.3).
Access to primary health care
Access to health services is important in order to identify and treat diseases in a timely way. Many such chronic conditions are potentially preventable if treated early. Vaccination can be effective in the prevention of diseases such as influenza. A lack of primary health care in many Indigenous communities also contributes to the high prevalence of diseases such as diabetes and lung diseases.
Access to primary health care can affect outcomes in a range of headline indicators and strategic areas for action, including life expectancy, infant mortality, disability and chronic disease, early child development and growth, substance use and misuse, and functional and resilient families and communities. Poor health can also affect people’s educational attainment and ability to work.
KEY MESSAGES
In 2001-02, expenditure per Indigenous person on primary health care, including that paid through the Medicare Benefits Scheme, was less than half the expenditure per non-Indigenous person (table 9.3.1).
In 2004-05, the hospitalisation rate for Indigenous people with potentially preventable chronic conditions was 8 times the rate for non-Indigenous people, and the rate for potentially preventable acute conditions was 3 times the rate for non-Indigenous people (tables 9.3.2 and 9.3.4). For Type 2 diabetes, the Indigenous hospitalisation rate was 7 times the rate for non- Indigenous people (table 9.3.3).
Hospitalisation rates for influenza decreased for both Indigenous and non-Indigenous people between 2003-04 and 2004-05. However, the reduction was greater for non-Indigenous people (table 9.3.5).
Hospitalisation rates for Indigenous people for sexually transmitted infections were between 13 and
67 times the rates for non-Indigenous people in 2004-05 (table 9.3.6).
THINGS THAT WORK
The Marrang Aboriginal Child and Family Health Model was developed to improve access to health care services and health outcomes among Indigenous families living in Orange, NSW (box 9.3.2).
The Condom Social Marketing for Indigenous Australia project aims to reduce unplanned teenage pregnancies and the incidence of sexually transmitted infections in Indigenous communities (box 9.3.3).
Jirrawun Health, a non-government body based in Kununurra, WA, works with mainstream health care services to improve the health of the Gija people (box 9.3.4).
Mental health
Mental health is defined in terms of an individual’s ability to negotiate the daily challenges and social interactions of life without experiencing undue emotional or behavioural incapacity. For many Indigenous people, health, including mental health, is holistic - encompassing not just the physical wellbeing of the individual but the social, emotional, spiritual and cultural wellbeing of the community.
Issues of mental health and wellbeing cover a broad range of problems which can result from domestic violence, substance misuse, physical health problems, imprisonment, family breakdown and social disadvantage. For Indigenous people there are also broader social and historic issues, such as forced separation or forced relocation, which influence mental health and wellbeing.
KEY MESSAGES
In 2004-05, psychological distress data showed that 27 per cent of Indigenous adults had experienced a high to very high level of distress, compared with 13 per cent of non-Indigenous adults (figure 9.4.1).
In 2004-05, 56 per cent of Indigenous adults reported feeling calm or peaceful all or most of the time and 71 per cent reported being happy all or most of the time (table 9A.4.13).
From 2001-02 to 2004-05, Indigenous people had higher rates of hospitalisation for mental and behavioural disorders than non-Indigenous people (figure 9.4.3).
‘Life stress events’ has been identified as the factor most strongly associated with high risk of clinically significant emotional or behavioural difficulties in Aboriginal children. In WA, in 2001 and 2002, over one in five Aboriginal children aged 0–17 years were living in families where 7 to 14 major life stress events, such as death, imprisonment, violence and severe hardship, had occurred in the 12 months prior to the survey (Western Australian Aboriginal Child Health Survey) (section 9.4).
In WA, Indigenous children in remote communities had better mental health than those living in Perth, suggesting that growing up in very remote communities, where adherence to traditional culture and ways of life are strongest, may be protective against emotional and behavioural difficulties in Aboriginal children (Western Australian Aboriginal Child Health Survey) (section 9.4).
THINGS THAT WORK
The school-based ‘Family Wellbeing Empowerment Program’ for remote Indigenous school children in Cape York, Queensland, aims to enhance the life skills and psychosocial development of young Indigenous people (box 9.4.2).
In NSW, the Aboriginal Mental Health Workforce Training Program aims to increase the representation of Aboriginal people in mental health professions (box 9.4.2).
Proportion of Indigenous people with access to their traditional lands
Indigenous people derive social, cultural and economic benefits from their connection to traditional country. Culturally, access to land and significant sites may allow Indigenous people to practise and maintain their knowledge of ceremonies, rituals and history. Socially, land can be used for recreational, health, welfare and educational purposes. The economic benefits of land are discussed under ‘Economic Participation and Development’.
This indicator aims to show access by all Indigenous people to traditional lands. However, available data are for Indigenous adults in non remote areas, and are not representative of all Indigenous people.
KEY MESSAGES
In 2004-05, there were no data on access to traditional lands for people in remote or very remote areas.
The proportion of Indigenous adults living in nonremote areas who did not recognise an area as their homelands increased from 29 per cent in 1994 to 38 per cent in 2004-05 (figure 9.5.3).
In non-remote areas, the proportion of Indigenous adults who lived on their homelands decreased from 22 per cent in 1994, to 15 per cent in 2004-05. The proportion who were allowed to visit their homelands remained steady, ranging from 44 per cent to 48 per cent, between 1994 and 2004-05 (figure 9.5.3).
Participation in organised sport, arts or community group activities
Taking part in organised sport, arts or community group activities can foster self-esteem, social interaction and the development of skills and teamwork. Early participation in these activities can lead to stronger bodies, the prevention of chronic diseases and improved learning and academic performance. Reductions in substance misuse, self-harm, and crime may also result.
KEY MESSAGES
In 2002, almost one quarter of Indigenous people aged 15 years and over had attended an Aboriginal or Torres Strait Islander ceremony in the previous 12 months (ABS 2004). Indigenous people in remote areas were three times more likely to have attended an Aboriginal or Torres Strait Islander ceremony than those in non-remote areas (ABS 2006).
The proportion of Indigenous people who were engaged in moderate or high levels of exercise decreased from 30 per cent in 1995 to 24 per cent in 2004-05 (table 9A.6.2).
THINGS THAT WORK
In the Tirrapendi Aboriginal Youth Disco Program in SA, police and Aboriginal families work together to plan and supervise Aboriginal youth discos (box 9.6.2).
Blue Light NT conducts self-supporting discos at remote communities such as Milingimbi and Ramingining (box 9.6.2).
In 2006, the Little Yuin Aboriginal Preschool established a holiday program at Wallaga Lake in NSW (box 9.6.3).
The Swan Nyungar Sports Education Program at Balga Senior High School, WA, aims to encourage Aboriginal students at school and improve their success, participation in post-school education and employment prospects (box 9.6.4).
The Rumbalara Football and Netball Club in Shepparton, Victoria, operates programs that support education, employment and healthy lifestyles (box 9.6.5).
The Athletics for the Outback Program focuses on remote and rural Indigenous communities, and provides resources and assistance to create a ‘whole of life’ activity linking education, life skills and responsibilities with sport (box 9.6.6).
Yirra Yaakin, established in WA in 1993, has become a world class theatre company and leader in community development, supporting positive self enhancement through artistic expression (box 9.6.7).
The Australian Government has supported independent Indigenous broadcasters since 1987. It has agreed to fund a National Indigenous Television Service. The ABC and SBS also provide Indigenous television programming (box 9.6.8).
Engagement with service delivery
Engagement with service delivery covers both impediments to Indigenous people accessing services and the appropriate delivery of services (including culturally relevant programs). In remote areas, lack of services and long distances create additional barriers to access.
KEY MESSAGES
In 2002, based on survey data, Indigenous people aged 55 years and over had the most difficulty
understanding and being understood by service providers (table 9A.7.7).
In 2004-05, an estimated 26 500 Indigenous adults needed to go to hospital in the previous 12 months, but did not go because of cost, personal reasons, logistical reasons or other barriers (figure 9.7.1 and table 9A.7.1).
The Western Australian Aboriginal Child Health Survey found that even though there was a high proportion of Aboriginal children at high risk of clinically significant emotional and behavioural difficulties, very few children had had contact with Mental Health Services (section 9.7).
THINGS THAT WORK
From 2001 to 2005 the Sharing the True Stories project identified and addressed communication barriers between Indigenous patients and health care workers (box 9.7.2).
The Jalaris Aboriginal Corporation (WA) coordinates a holistic approach to family strength and health issues (box 9.7.3).
The Improving Care for Aboriginal and Torres Strait Islander Patients program aims to improve identification of, and quality care for, Aboriginal and Torres Strait Islander patients in Victoria (box 9.7.4).
15 people in Port Augusta with Aboriginal language skills received training to become accredited interpreters (box 9.7.5).
Improvements to Medicare and Pharmaceutical Benefits Scheme (PBS) arrangements have improved access to health care for Indigenous people (box 9.7.6).
The book ‘Yarning about Mental Health’ uses pictures and traditional Aboriginal stories to identify and explain some of the causes, symptoms and treatments of mental health problems (box 9.7.7).
A pre-hospital care model for remote Indigenous communities has been implemented in Coen, Horn Island, Cooktown and Kowanyama in Queensland (box 9.7.8).
Report Chapter 9: Functional and resilient families and communities
(PDF document)
Attachment 9A
(Excel document)
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