Part 4: Important Considerations in Suicide Prevention with Indigenous Communities and Services

Genuine Engagement and partnership with Aboriginal and Torres Strait Islander communities

Engagement with Elders

Policy document Reference Description
Korin Korin Balit-Djak (2017-27) Strategic direction 1.2.1, p.28
  • Better engagement and supports for Aboriginal Elders
  • Over the next three years, the department will:
    • Increase supports for Aboriginal Elders to live well – with a focus on community participation.
    • Engage with Aboriginal communities to better understand the health, wellbeing and safety needs and aspirations of Aboriginal Elders.
    • Promote access to public sector-funded residential aged care services for Aboriginal Victorians through providing more culturally relevant information.
    • Build the capacity of public sector residential aged care services to deliver culturally safe care.
    • Increase access to Aboriginal-specific information for Aboriginal older people through the Seniors Online portal.
    • Develop culturally responsive supports for Aboriginal Elders affected by elder abuse and family violence.
    • Support and facilitate the relocation of Aboriginal Elders wanting to retire on country.
    • Resource Aboriginal organisations, Gathering Places and Aboriginal groups to deliver local place-based projects that will enable Elders to engage with each other and share knowledge to build resilience, health, wellbeing and safety in community through mentoring and supporting young people, families and each other.
    • Resource Aboriginal organisations, Gathering Places and Aboriginal groups to enable Elders to participate and contribute to local and regional engagement, governance and co-design and to facilitate participation in the planning and delivery of cultural activities.
  • In 10 years, success will look like:
    • More Aboriginal Elders are actively involved and contributing to their communities, and their overall health, wellbeing and safety is improved.

Broader engagement and partnership/ co-design

CBPATSISP’s indigenous Governance Framework provides an in-depth discussion of the principles and importance of Indigenous governance in the context of developing, implementing and evaluating suicide prevention programs and services.

Policy document Reference Description
Fifth Plan (2017–23) Action 10. P33
  • Engagement in planning… involvement of ACCHS and… communities [and includes] for Aboriginal and Torres Strait Islander peoples at the regional level Aboriginal and Torres Strait Islander presence on PHN/LHD governance structures and Aboriginal and Torres Strait Islander leadership on local mental health/ related services
Action 11, ATSIMHSPS TOR 4
  • Provide advice on suitable governance for services and the most appropriate distribution of roles and responsibilities, recognising that the right of Aboriginal and Torres Strait Islander communities to self-determination lies at the heart of community control in the provision of health services
MH&SEWB Fr (2017–23) Outcome 2.1, p.32
  • Engage Elders and senior community members in leadership roles in a culturally-informed way…
  • Support men’s and women’s groups and gender-specific promotion of leadership…
  • Support community governance through community controlled services to deliver health programs and services.
Outcome 1.3, p.31
  • Formalise effective partnerships to achieve the best possible MH&SEWB… outcomes for Aboriginal and Torres Strait Islander people in all regions, including by implementing integrated planning and service delivery for Aboriginal and Torres Strait Islander people at the regional level.
Drug Strategy (2014–19) Outcome 2.2, p.6
  • Participation of Aboriginal and Torres Strait Islander people using AOD services is improved.
Priority Area 3, p.5
  • Strengthen partnerships based on respect both within and between Aboriginal and Torres Strait Islander peoples, government and mainstream service providers, including in law enforcement and health organisations, at all levels of planning, delivery and evaluation.
Outcome 3.1, p.6
  • Community driven partnerships are strengthened at the local level to address harms associated with alcohol and other drugs.
Outcome 3.2, p.6
  • Community leaders and Elders take responsibility and a leading role, in partnership with government, to design, deliver and evaluate alcohol, tobacco and other drugs programs.
NATSIHP/IP (2013–2023) Strategy 5C, p.36
  • Aboriginal and Torres Strait Islander adults contribute to the development of strategies and services that promote healthy behaviours, family cohesion, and social and emotional wellbeing.
  • ACCHSs are funded to engage locally to identify priorities and develop responses.
Strategy 6D, p.40
  • Local elders and senior community members are recognised and valued as experts who can help improve local health and wellbeing outcomes.
Cultural RF (2016–26) Domain 5, p.16
  • Participatory and collaborative partnerships with communities and a variety of formal and informal mechanisms are to facilitate community involvement in developing and implementing cultural safety and responsiveness related activities
  • Governance structures support systematic and ongoing two–way communication with Aboriginal and Torres Strait Islander communities, particularly in relation to policy development, program planning, service delivery, evaluation of services, and quality improvements
  • Collaboration and partnerships with Aboriginal and Torres Strait Islander communities to actively respond to the challenges faced when engaging with the health service/system
Domain 4, p.15
  • Governance structures support and facilitate partnerships with Aboriginal and Torres Strait Islander communities and health consumers to design the way care is delivered
  • Polices and processes are established and maintained to include Aboriginal and Torres Strait Islander communities and health consumers in policy development, service planning and care design
  • Organisational commitment to training of health professionals to support Aboriginal and Torres Strait Islander consumers involvement in health care design and delivery
Korin Korin Balit-Djak (2017–27) Priority focus 1.1, p.17
  • Aboriginal communities self-determine health, wellbeing and safety. The department’s goal is to support and strengthen Aboriginal leadership in government so that the aspirations and perspectives of Aboriginal communities are better reflected in governmental strategic planning and decision-making.
Strategic direction 1.1.1, p.18 Increase Aboriginal involvement in leadership and strategic government decision-making
4. Proactively support Aboriginal and Torres Strait Islander engagement and participation in the co-design, development and delivery of Aboriginal and Torres Strait Islander programs and services to maximise outcomes (Department of Aboriginal and Torres Strait Islander Partnerships/all agencies).

  • Over the next three years, the department will:
    • Prioritise and include Aboriginal people’s expertise and experience, both internal and external to the department, in government decision-making and policy making.
    • Resource Aboriginal organisations to undertake policy, advocacy and consultative work to inform government service delivery and legislative reform.
    • Increase the use of Aboriginal research methods, evaluations and evidence to develop, implement and promote services and programs that work both in the department and in the community.
    • Share and promote ‘best practice’ Aboriginal leadership through conferences and expos led by Aboriginal organisations.
    • Support our employees’ understanding and application of Aboriginal self-determination in health, wellbeing and safety through ongoing seminars, workshops, learning materials and leadership commitments.
  • In 10 years, success will look like:
    • Aboriginal people and communities are leading strategic government decision-making in Aboriginal health, wellbeing and safety.
    • Aboriginal organisations are adequately resourced to participate effectively in policy and program development, and legislative reform
Qld Aboriginal and Torres Strait Islander SEWB Action Plan (2016–18) Action 4, p.18
  • Proactively support Aboriginal and Torres Strait Islander engagement and participation in the co-design, development and delivery of Aboriginal and Torres Strait Islander programs and services to maximise outcomes (Department of Aboriginal and Torres Strait Islander Partnerships/all agencies).
PHN Guide
  • See Primary Health Networks and Aboriginal Community Controlled Health Organisations Guiding Principles (March 2016)

Planning partnerships with ACCHSs

Policy document Reference Description
MH&SEWB Fr
(2017–23)
Outcome 1.3, p.31
  • Effective partnerships between PHNs/ ACCHSs
  • Formalise effective partnerships to achieve the best possible MH&SEWB… outcomes for Aboriginal and Torres Strait Islander people in all regions, including by implementing integrated planning and service delivery for Aboriginal and Torres Strait Islander people at the regional level.
  • Ensure planning strategies incorporate the joint planning processes of the state and territory-level Aboriginal and Torres Strait Islander health planning for a.
Outcome 4.3, p.41
  • Primary Health Networks work in partnership with Aboriginal Community Controlled Health Services on a regional or other geographical basis to: identify and map relevant services and agencies; and develop, promote and regularly review culturally and clinically appropriate pathways between them – in particular, for the treatment of trauma and emotional and behavioural difficulties in children.
Cultural RF
(2016–26)
Domain 3, p.14
  • Partnerships established with ACCHSs to collaborate and share best practice in supporting health professionals to provide culturally safe and responsive health services to communities
Domain 5, p.16
  • Partnerships with Aboriginal and Torres Strait Islander organisations to jointly recognise, celebrate and actively participate in historical events of significance and important annual events that recognise and promote culture (e.g. Close the Gap, National Reconciliation Week, Mabo Day, NAIDOC Week, Coming of the Light, Harmony Day, and National Sorry Day)
Domain 2, p.13
  • Working with local Aboriginal and Torres Strait Islander people and organisations, as well as interpreter/ translation services, to support communication with Aboriginal and Torres Strait Islander consumers to provide more effective and quality health care, while improving access and pathways of care between organisations and mainstream services
Drug Strategy
(2014–19)
Outcome 3.1 p.6
  • Community driven partnerships are strengthened at the local level to address harms associated with alcohol and other drugs.
Outcome 3.2, p.6
  • Community leaders and Elders take responsibility and a leading role, in partnership with government, to design, deliver and evaluate alcohol, tobacco and other drugs programs.
Outcome 3.3, p.6
  • Partnerships between Aboriginal and Torres Strait Islander community‐controlled AOD services and mainstream AOD services are enhanced and strengthened
Outcome 3.4, p.6
  • Partnerships between government and AOD service providers (both community‐ controlled and mainstream services) are based on mutual respect and community strengths.
Korin Korin Balit-Djak (2017–27) Strategic direction 1.1.2, p.19
  • Prioritise funding to Aboriginal organisations
  • Over the next three years, the department will:
    • Review existing funding and identify areas for application of prioritising funding policy to:
      • develop a transition and implementation plan for a new way of funding
      • develop tools, resources and capabilities to support the transition and implementation
      • monitor the impact of the prioritised funding policy and refine where necessary.
    • Enable and resource Aboriginal organisations to undertake workforce planning and development to build the capacity needed to transition services to community control.
    • Develop outcomes-based and streamlined reporting requirements with Aboriginal organisations that are flexible and centred on improving Aboriginal health, wellbeing and safety outcomes, and on identifying opportunities to trial outcomes-based funding.
    • Promote commissioning criteria and assessment processes that prioritise funding to Aboriginal communities and organisations through the Primary Health Networks.
    • Review the reporting and accreditation requirements of Aboriginal organisations and explore recognition of accreditation standards.
  • In 10 years, success will look like:
    • Aboriginal communities and organisations are appropriately resourced to design, develop and deliver services that address their communities’ health, wellbeing and safety needs and aspirations.
    • Aboriginal-specific funding is provided directly to Aboriginal organisations as standard practice.
    • Funding is outcomes based and reporting requirements are flexible and centred on improving Aboriginal health, wellbeing and safety outcomes.
    • Aboriginal agency funding is provided on a long-term (minimum of five years) basis as a matter of course.
Strategic direction 1.1.3 Increase investment in capital infrastructure of Aboriginal community-controlled organisations

  • Over the next three years, the department will:
    • Improve access for Aboriginal organisations to infrastructure grant programs.
    • Undertake an infrastructure needs assessment in conjunction with Aboriginal organisations building on the Aboriginal Victoria 2012 needs assessment.
    • Strengthen the focus within the Statewide Design, Service and Infrastructure Plan for Victoria’s Health System on the needs of Aboriginal people and the opportunities offered by Aboriginal community-controlled organisations and Gathering Places.
    • Ensure that funding arrangements acknowledge the time required to undertake genuine consultation and build programs that address community needs and strengths.
  • In 10 years, success will look like:
    • The infrastructure needs of Aboriginal organisations are embedded into statewide health and human services infrastructure planning, and Aboriginal communities’ investment needs are prioritised.
NSQHS Standards (2017) Action 2.13, p.19
  • The health service organisation works in partnership with Aboriginal and Torres Strait Islander communities to meet their healthcare needs
NSQHS Standards User guide (2017) Re above, key tasks, p.8
  • Identify Aboriginal and Torres Strait Islander communities within the organisation’s catchment, and the relevant cultural protocols to guide building of partnerships
  • Identify key contacts, elders and opinion leaders in the Aboriginal and Torres Strait Islander communities and health services and make contact with them
  • Establish and implement mechanisms for forming and maintaining partnerships with Aboriginal and Torres Strait Islander communities and representative organisations.
Nat Standards MH Services (2013) Standard 4
  • The MHS delivers services that take into account the cultural and social diversity of its consumers and meets their needs and those of their carers and community throughout all phases of care.
Criteria 4.2, p.12
  • The MHS whenever possible utilises available and reliable data on identified diverse groups to document and regularly review the needs of its community and communicates this information to staff.
Criteria 4.1
  • Public mental health services and private hospitals p.18.The MHS identifies the diverse groups [inc.] Aboriginal and Torres Strait Islander people that access the service. … This information should be used to plan and develop culturally competent services and strategies to improve access to the service…. The MHS should provide evidence that it uses methods such as: collaboration with community health and welfare organisations and services to develop local protocols for Aboriginal and Torres Strait Islander people…. [and] develop relationships with local Aboriginal and Torres Strait Islander elders and peak groups.
Criteria 4.4, p.19
  • The MHS should develop appropriate partnerships with other service providers, organisations and programs with diversity experience as part of its commitment to self-determination for Aboriginal and Torres Strait Islander people

Supporting SEWB, culture and cultural practice as primordial prevention

Policy document Reference Description
Korin Korin Balit-Djak (2017–27) Chapter 2 See this Chapter on: Prioritising Aboriginal culture and community
National Empowmt. Project Voices of the Peoples: Research Report See: http://media.wix.com/ugd/396df4_85c3278f13ce47149bc394001d69dad6.pdf

Addressing community challenges as primordial prevention

Policy document Reference Description
National Empowmt. Project Voices of the Peoples: Research Report See: http://media.wix.com/ugd/396df4_85c3278f13ce47149bc394001d69dad6.pdf

Indigenous led governance and evaluations

Policy document Reference Description
Korin Korin Balit-Djak (2017–27) Strategic direction 3.3.1
  • Over the next three years, the department will:
    • Establish integrated and representative structures to guide the implementation, governance, monitoring and accountability of Korin Korin Balit-Djak through the implementation of the Aboriginal governance and accountability framework.
    • Establish an Aboriginal community-led governance and accountability mechanism that externally evaluates and monitors the department’s progress against achieving the vision of Korin Korin Balit-Djak.
    • Commission an Aboriginal organisation to develop an Aboriginal community-led monitoring and evaluation framework through community consultation to determine Aboriginal-defined indicators, targets and measures of success for Korin Korin Balit-Djak.
    • Appoint an independent Aboriginal person as chair of the Department Evaluation Committee.
    • Regularly report on the findings of monitoring and evaluation to Aboriginal organisations and communities.
    • Invest in Aboriginal organisations to develop research and evaluation capacity in health, wellbeing and safety.
    • Share knowledge of effective and culturally appropriate approaches to manage and respect intellectual property, program delivery and evaluation.
    • Investigate and develop a model to establish an Aboriginal health, wellbeing and safety ethics committee.
  • In 10 years, success will look like:
    • Aboriginal communities lead the implementation, governance, monitoring and evaluation of Aboriginal health, wellbeing and safety.
    • All programs and policies of relevance to Aboriginal Victorians will be developed in reference to Aboriginal definitions of success, and evaluated by Aboriginal organisations and communities.
    • All Aboriginal-specific research in health, wellbeing and safety will be approved by an Aboriginal research ethics committee.
    • Strategic direction 3.3.2: Increase
Workforce

Overarching Workforce Strategy for mental health and suicide prevention

Policy document Reference Description
Fifth Plan (2017–23)  Action 31, p.47
  • Workforce Development Program -To meet future workforce supply requirements and drive recruitment and retention of skilled staff
Action 11, ATSIMHSPS TOR 6
  • Provide advice on workforce development initiatives that can grow and support an Aboriginal and Torres Strait Islander MH workforce, incorporate Aboriginal and Torres Strait Islander staff into multidisciplinary teams….
MH&SEWB Fr (2017–23) Outcome 1.1, p.28
  • Increase Aboriginal and Torres Strait Islander employment across the entire MH&SEWB workforce, including psychologists and psychiatrists, speech pathologists, mental health workers and other professionals and workers.
Outcome 4.2. p.40
  • Ensure the required mix and level of specialist mental health services and workers, paraprofessionals and professionals required to meet the mental health needs of the Aboriginal and Torres Strait Islander people, including specialist suicide prevention services for people at risk of suicide
GDD (2017) Theme 4, p.5
  • Aboriginal and Torres Strait Islander people should be trained, employed, empowered and valued to work at all levels and across all parts of the Australian mental health system and among the professions that work in that system.
NATSIHP/IP (2013–23) Strategy 1A, p.11
  • Core services framework for comprehensive primary health care and access to specialist medical care has been defined and considered by the Minister as a matter of priority. (This model will be influenced by, and will directly influence, the Aboriginal and Torres Strait Islander Health Workforce Strategic Framework).
Strategy 1E, p.17
  • Aboriginal and community controlled and mainstream health sector workforces are capable of meeting the needs of Aboriginal and Torres Strait Islander people
  • Support, grow and increase the capability of the workforce… to meet current and future Aboriginal and Torres Strait Islander health needs
  • The National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework (2011–2015) has been reviewed and a new framework developed and implemented.
SP Workforce Development and Training Plan for Tasmania (2016–2020) Actions pp 14 – 22
  • Workforces likely to interact with people experiencing a suicidal crisis. Requirement: Tailored training for role and setting which focuses on person-centred risk identification and immediate management of those at risk (p.14–15)
  • Health (and other) workers likely to interact with those at risk of suicide and/or needing ongoing management and care. Requirement: Tailored training for their role focused on identification of those at risk and ongoing support and management (p.16–17)
  • Non-health workforces that may interact with people at risk of suicide or those impacted by suicide. Requirement: General knowledge and skills about suicide prevention, early intervention and postvention that is tailored for their specific role or setting (p.18–20)
  • Families and carers, community groups and general workforces interacting with the community and all other workforces. Requirement: General knowledge and skills about suicide prevention, early intervention and postvention (p.21–22).
Drug Strategy
(2014–19)
Priority Area 1, p.5
  • Build capacity and capability of the AOD service system, particularly Aboriginal and Torres Strait Islander community-controlled services and its workforce, as part of a cross-sectoral approach with the mainstream AOD services to address harmful AOD use.
Outcome 1.3, p.5
  • Workforce initiatives are developed to enhance the capacity and capability of community‐controlled AOD services.
Cultural RF
(2016–26)
Domain 3, p.14
  • Aboriginal and Torres Strait Islander people working in all areas of the health sector, both clinical and non- clinical, and adequate resources allocated over the long-term to support targeted employment strategies and initiatives
  • Aboriginal and Torres Strait Islander health professionals actively supported and retained in the health system through capacity building, mentoring initiatives and ongoing career progression, in both targeted and mainstream positions
National Aboriginal and Torres Strait Workforce Strategy (2016–23) Strategy 1, p.8
  • Improve recruitment and retention of Aboriginal and Torres Strait Islander health professionals in clinical and non-clinical roles across all health disciplines (See Suggested mechanisms)
National MH Workforce Strategy (2011) p.17 (text)
  • In order to provide culturally appropriate services for people from Aboriginal and Torres Strait Islander and culturally and linguistically diverse (CALD) backgrounds, the workforce needs to be technically and culturally competent. In some situations, the MH workforce may be able to be drawn from people of an appropriate cultural background, but in most situations, services to people from Aboriginal and Torres Strait Islander and CALD backgrounds are provided by workers from a different cultural background who need training and support to ensure they are culturally aware and competent.
  • Aboriginal and Torres Strait Islander MH workers may need support, owing to their dual roles at work and in their own family groups and communities. These workers, particularly in remote communities, face particular pressures and are often on call 24 hours a day, seven days a week. To compound the pressure, they work in many rural and remote areas of Australia, and Indigenous workers may not be eligible for housing and other supports made available to non-Indigenous staff and visiting specialists.
  • Ongoing cultural competence in-service training, rather than brief awareness sessions, was the favoured strategy for building workforce capacity. The generalist mental health workforce may also benefit from education programs that focus on the settlement challenges of newly arrived migrants and refugees, and how failure to overcome these challenges can develop into acculturation difficulties and subsequent MH deterioration…
Objective 3.3.1, p.28
  • Work with the CALD sector and MH services to promote career opportunities within the MH sector to meet the changing demographics of MH populations.
Objective 3.2.1, p.28
  • Support the training of Aboriginal and Torres Strait Islander to become MH workers in a range of disciplines by supporting and promoting existing successful programs and piloting new programs.
Korin Korin Balit-Djak (2017–27) Strategic direction 3.2.1
  • Grow recruitment and retention of the Aboriginal workforce
  • Over the next three years, the department will:
  • Across the department:
    • Continue efforts to implement the department’s Aboriginal employment strategy.
    • Expand and implement employment exchange programs between the department and Aboriginal organisations to build knowledge, understanding and skill level of Aboriginal staff and non-Aboriginal staff across the health and human services sector.
    • Ensure the two per cent target of Aboriginal employees within the department is met by 2021.
    • Implement a professional development program for all Aboriginal staff to support career advancement and increase Aboriginal staff in senior roles.
    • Increase the number of Aboriginal staff in child protection at all levels and in all areas.
    • Continue to support the department’s Aboriginal Staff Support Network.
  • Across the health and human services sector:
    • Deliver an Aboriginal health and human services workforce strategy to support and grow the Aboriginal workforce across all levels of the health and human services sector.
    • Increase the number of Aboriginal people in senior roles in the health and human services workforce by extending professional development and careers opportunities for Aboriginal employees.
    • Expand the skills and availability of Aboriginal health and human services workers in both mainstream and Aboriginal organisations.
    • Develop, implement and resource flexible education to career pathways that support the Aboriginal workforce to gain formal qualifications that recognise Aboriginal knowledge and skills.
    • Undertake research to understand opportunities and barriers for Aboriginal workers to support the department’s approaches.
    • Continue to develop sectoral partnerships and collaborations between schools, employment providers and other educational institutions to promote career development pathways for Aboriginal people.
    • Support the development and implementation of culturally appropriate leadership and mentoring programs for Aboriginal organisations.
    • Co-design supervision and support mechanisms for Aboriginal employees working in hospitals, mental health and human services to manage isolation, cultural load and vicarious trauma.
    • Establish an Aboriginal employment staff support network across the health and human services sector.
    • Work with Aboriginal organisations, health and human service organisations and peak bodies to improve Aboriginal employment conditions, career opportunities and recognition.
  • In 10 years, success will look like:
    • The department’s Aboriginal employment targets have been met or exceeded.
    • Aboriginal employment plans will be developed and implemented across all areas of the health and human services sector.
    • The Aboriginal workforce is represented in non-clinical and clinical roles at all levels to ensure a culturally safe health and human services sector.
    • Cultural safety for the Aboriginal workforce is understood, embraced and practised across the Victorian health and human services sector.

Upskilling existing Aboriginal and Torres Strait Islander workers

Policy document Reference Description
MH&SEWB Fr (2017–23) Outcome 1.1, p.28
  • Improve the status of all Aboriginal and Torres Strait Islander MH&SEWB workers, paraprofessionals and professionals and over time, require workers to have qualifications that ensure professional equity.
  • Progress initiatives that support … workforce-wide up-skilling, including appropriate clinical supervision of MH&SEWB workers, paraprofessionals and professionals
  • Create career pathways by reducing barriers and pathways to education and training including training for emerging professional workforces accredited workers, paraprofessionals and established professionals and professions.
  • Continue to develop accreditation standards that are systematically measurable; and develop and support pathways to training in existing work environments to increase worker and professional capacities.
NATSIHIP/IP (2013–23) Strategy 1E, p.17
  • Training opportunities provided to further develop the skills of staff to meet current and future Aboriginal and Torres Strait Islander health service needs and increase retention levels.
National Aboriginal and Torres Strait Workforce Strategy (2016–23) Strategy 2, p.8
  • Improve the skills and capacity of the Aboriginal and Torres Strait Islander health workforce in clinical and non-clinical roles across all health disciplines (See Suggested mechanisms)
Strategy 3 p9
  • Health and related sectors be supported to provide culturally-safe and responsive workplace environments for the Aboriginal and Torres Strait Islander workforce. (See Suggested mechanisms)
National MH Workforce Strategy (2011) Objective 1.2.1, p.20
  • Provide better career pathways, supervision, mentoring and locum support programs for Aboriginal MH workers in a range of settings.

Training/support all MH service staff

Policy document Reference Description
National MH Workforce Strategy (2011) Objective 1.2.2, p.20
  • Incorporate training in Aboriginal and Torres Strait Islander mental health in MH workforce training programs.
NSQHS Standards (2017) Action 1.21
  • The health service organisation has strategies to improve the cultural awareness and cultural competency of the workforce to meet the needs of its Aboriginal and Torres Strait Islander patients
MH&SEWB Fr (2017–23) Outcome 1.1.10, p.29
  • Require cultural competence of general practitioners and other medical practitioners in order to work effectively with Aboriginal and Torres Strait Islander with MH problems and mental illness
NATSIHIP/IP (2013–23) Strategy 1E, p.17
  • Training needs of health sector staff working with Aboriginal and Torres Strait Islander peoples have been identified and addressed, including the development and delivery of new training programmes.
Fifth Plan (2017–23) Action 12.4, p.34
  • Training all staff delivering mental health services to Aboriginal and Torres Strait Islander peoples, particularly those in forensic settings, in trauma-informed care…
Cultural RF (2016–26) Domain 2, p.13
  • Health staff have access to resources and training to guide and support culturally safe communication with health consumers (e.g. interpreters, liaison officers, traditional healers, translated resources and health information packages)
Domain 3, p.14
  • Budget and resources to support adequate cultural safety and responsiveness training of health staff at all levels (clinical and non-clinical) and across all disciplines, including ongoing professional development, capacity for self-reflection and monitoring of health staff skills
Cultural competence and safety as key to service accessibility

In general

Policy document Reference Description
NSQHS Standards (2017) Action 1.2, p.6
  • The governing body ensures that the organisation’s safety and quality priorities address the specific health needs of Aboriginal and Torres Strait Islander people
Action 1.4, p.6
  • The health service organisation implements and monitors strategies to meet the organisation’s safety and quality priorities for Aboriginal and Torres Strait Islander people
National Standards – MH Services (2013) Criterion 4.2 Implementation Guidelines– Public Mental Health Services and Private Hospitals, p.18

  • The MHS should have documented evidence to show:
    • the provision of training to all staff, including management, on the diversity of needs within its catchment and on culturally competent service delivery
    • how the service’s relevant committees and working groups consult with and represent Aboriginal and Torres Strait Islander communities
    • how and when the MHS engages interpreters.
  • Policies, procedures and work practices that recognise, and are responsive to, the needs of the MHS community include… identifying the social and cultural customs and values of Aboriginal and Torres Strait Islander people in the community

Implementation Guidelines for Non-government Community Services, p.34

  • Responses should address attitudinal, physical, and procedural barriers. Evidence that this criterion is met could include:
    • respect for and responsiveness to diversity in service delivery principles and values statements
    • documenting that staff have been trained in cross cultural awareness
    • documenting the use of interpreters with consumers and carers who are not proficient in English or who are deaf
    • board membership and staffing reflecting community diversity
    • specialist positions in the organisation, for example culturally and linguistically diverse and Aboriginal and Torres Strait Islander liaison staff

Implementation Guidelines for Private Office-based Mental Health Practices, p.15

  • The MHS should have documented evidence to show:
    • how consultation and representation of Aboriginal and Torres Strait Islander communities are sought within the service’s relevant committees and working groups
    • how and when the MHS engages interpreters.
    • Policies, procedures and work practices that recognise and are responsive to the needs of the MHS community include: the social and cultural customs and values of Aboriginal and Torres Strait Islander people identified within its community
Standard 6, p,14
  • Consumers have the right to comprehensive and integrated MH care that meets their individual needs and achieves the best possible outcome in terms of their recovery.
Criterion 6.7, p.14
  • Implementation Guidelines for Private Office-based Mental Health Practices p.23 – Each consumer participates fully in the development of the individual treatment, care and recovery plan… For Aboriginal and Torres Strait Islander people involvement of community and family may be essential in the development of such plans.
Criterion 10.2.1, p.22
  • The MHS is accessible to the individual and meets the needs of its community in a timely manner.
Criterion 10.2.1
  • Implementation Guidelines for Non-government Community Services, Service providers should pay particular attention to the diversity of its individuals: [inc.] Aboriginal and Torres Strait Islander people
NSQHS Standards (2017) Action 1.33 p.12
  • The health service organisation demonstrates a welcoming environment that recognises the importance of the cultural beliefs and practices of Aboriginal and Torres Strait Islander people
NSQHS Standards – Aboriginal and Torres Strait Islander User Guide (2017) Key Task (KT) 1.2, p.3
  • The governing body ensures that the organisation’s safety and quality priorities address the specific health needs of Aboriginal and Torres Strait Islander people
KT 1.4, p.3
  • The health service organisation implements and monitors strategies to meet the organisation’s safety and quality priorities for Aboriginal and Torres Strait Islander people
KT 1.21, p.3
  • The health service organisation has strategies to improve the cultural awareness and cultural competency of the workforce to meet the needs of its Aboriginal and Torres Strait Islander patients
KT 1.33, p.3
  • The health service organisation demonstrates a welcoming environment that recognises the importance of cultural beliefs and practices of Aboriginal and Torres Strait Islander people
Fifth Plan (2017–23) Action 11, ATSIMHSPS TOR 7
  • Provide advice on models of service delivery that embed cultural capability into all aspects of clinical care and implement the Cultural Respect Framework in MH services
Strategy 10, p.14
  • Operationalising the Cultural Respect Framework…
NATSIHP/ IP (2013–23) Strategy 1B, p.12
  • Indicators for measuring cultural safety, such as discharge from hospitals without medical advice, and elimination of the differentials in access to best practice clinical care for Aboriginal and Torres Strait Islander patients irrespective of geography and socioeconomic status will be considered in the preparation of the data development plan
  • Guidance on the provision of clinically competent and culturally safe services (including MH) has been provided and implemented.
Cultural Respect Framework (2016–26) Domain 1, p.12
  • Organisational leadership actively models cultural safety and responsiveness by staff at all levels and across the organisation
  • Formal organisational commitment to improving cultural safety and responsiveness is visible in all aspects of core business, including vision and mission statements, organisational principles and values, and continuous improvement activities
  • Executive-level responsibility for implementing and monitoring cultural safety and responsiveness across health organisations and systems against health outcomes
  • Recognition for leaders of cultural safety and responsiveness, highlighting their activity and sharing of best- practice initiatives across the organisation
  • Recognise and celebrate historical events of significance and important annual events (e.g. Close the Gap, Mabo Day, etc.) as a normal part of business
  • Organisational policy to support culturally safe and responsive practice in health services and systems, including particular support for training and professional development towards cultural capabilities
  • Procurement policies bind assessment of providers, and provision of procured services, to cultural safety standards
  • Data collection capacity and mandated performance indicators to ensure cultural safety targets are being achieved and service delivery is improving
  • Resources and materials provided to inform all staff, as well as Aboriginal and Torres Strait Islander people, about the cultural safety and responsiveness efforts
  • Adequate funding investment and resourcing for Aboriginal and Torres Strait Islander cultural safety initiatives and related service improvements across all levels of the organisation
Domain 2, p.13
  • Organisational commitment recognising diversity of Aboriginal and Torres Strait Islander communities and consumers
  • All health professionals have the opportunity to participate in Aboriginal and Torres Strait Islander cultural events to foster greater understanding of social and cultural issues to inform holistic practice
  • Organisational resources committed to regularly informing the community about cultural safety and responsiveness progress and innovations Culturally safe and responsive environments are developed (e.g. specific literature, artworks, flags, posters and decor) and physical environment designed with consideration for Aboriginal and Torres Strait Islander consumers
Domain 3, p.14
  • Budget and resources to support adequate cultural safety and responsiveness training of health staff at all levels (clinical and non-clinical) and across all disciplines, including ongoing professional development, capacity for self-reflection and monitoring of health staff skills
  • Health professionals can identify the need for, and actively seek, advice, assistance and input from Aboriginal and Torres strait Islander staff who are available to inform culturally responsive service provision
  • Partnerships established with ACCHOs to collaborate and share best practice in supporting health professionals to provide culturally safe and responsive health services to communities
Domain 6, p.17
  • Organisations conduct initial and ongoing organisational assessments of cultural safety and responsiveness related activities, and are encouraged to integrate cultural and linguistic responsiveness related measures into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes based evaluations
National Standards MH workforce (2013) Standard 3
  • The social, cultural, linguistic, spiritual and gender diversity of people, families and carers are actively and respectfully responded to by mental health practitioners, incorporating those differences into their practice.
Cultural Respect Framework (2016–26) Domain 2, p.13
  • Mechanisms and processes to respond to, and support, the linguistic diversity of Aboriginal and Torres strait Islander consumers
  • Aboriginal and Torres Strait Islander culture and languages are considered in decision-making about health care needs—including the use of interpreter and support services—at all points of contact throughout the consumer journey, particularly when informed consent is required
  • Health staff have access to resources and training to guide and support culturally safe communication with health consumers (e.g. interpreters, liaison officers, traditional healers, translated resources and health information packages)
  • Communication pathways are established to share examples of best practice health literacy and improved communication throughout health services, settings and sectors
  • Working with local Aboriginal and Torres strait Islander people and organisations, as well as interpreter/ translation services, to support communication with Aboriginal and Torres strait Islander consumers to provide more effective and quality health care, while improving access and pathways of care between organisations and mainstream services
MH&SEWB Fr (2017–23) Outcome 3.3, p.38
  • Support access to cultural liaison officers and language interpreters (See also 4.2.6/ 4.3.4)
National Standards – MH Workforce (2013) Standard 3, p.14
  • The MH practitioner:
    • 10. Communicates effectively with the person and, where relevant, with family members and/or carers through the assistance of Aboriginal and Torres strait Islander health and/or MH professionals, interpreter services and bilingual counsellors
    • 11. Liaises and works collaboratively with culturally and linguistically appropriate care partners such as religious ministers, spiritual leaders, traditional healers, local community-based organisations, Aboriginal and Torres strait Islander health and MH workers, health consumer advocates, interpreters, bilingual counsellors and other resources where appropriate
Standard 4
  • The MH practitioner: Uses culturally sensitive language and preferred terminology in line with current policy directives
National Standards – MH Services (2013) Criterion 4.2
  • Implementation Guidelines– Public Mental Health Services and Private Hospitals, p.18 The MHS should have documented evidence to show: how and when the MHS engages interpreters.
  • Implementation Guidelines for Non-government Community Services, p.34. Responses should address attitudinal, physical, and procedural barriers. Evidence that this criterion is met could include: documenting the use of interpreters with consumers and carers who are not proficient in English or who are deaf
  • Implementation Guidelines for Private Office-based Mental Health Practices. p.15 The MHS should have documented evidence to show: how and when the MHS engages interpreters.
Criterion 4.4
  • The MHS has demonstrated knowledge of and engagement with other service providers or organisations with diversity expertise / programs relevant to the unique needs of its community.
  • Implementation Guidelines– Public Mental Health Services and Private Hospitals, p.19. The MHS needs to demonstrate that it has policies and procedures that allow access to professional services—such as interpreters, Aboriginal and Torres strait Islander health workers, (etc)… The MHS needs to show how and when it will engage interpreters or bilingual workers to facilitate culturally appropriate assessment, diagnosis and treatment.
  • Implementation Guidelines for Private Office-based Mental Health Practices. p. 16. The use of interpreters or bilingual workers needs to be coordinated in consultation with the consumer and carer to ensure it is culturally sensitive.
  • Implementation guidelines for Non-government Community Services p.35. Staff should know how to access specialist services such as interpreters (including Auslan interpreters), and … Aboriginal and Torres strait Islander health workers.
Criterion 4.4
  • Implementation guidelines for Non-government Community Services, p.35. Staff should know how to access specialist services such as interpreters (including Auslan interpreters), and … Aboriginal and Torres Strait Islander health workers.
Criterion 4.2, p34
  • Responses should address attitudinal, physical, and procedural barriers. Evidence that this criterion is met could include: documenting the use of interpreters with consumers and carers who are not proficient in English or who are deaf
Fifth Plan (2017–23) Action 12.2, p.34
  • increasing knowledge of SEWB concepts, improving the cultural competence… of mainstream providers
MH&SEWB Fr (2017–23) Outcome 1.1, p.29
  • Require cultural competence of general practitioners and other medical practitioners in order to work effectively with Aboriginal and Torres Strait Islander people with MH problems and mental illness.
Outcome 4.2, p.40
  • Culturally and clinically appropriate specialist mental health care is available according to need
  • Incorporate cultural competency in the professional standards and responsibilities of mental health professions within a SEWB framework.
NATSIHP/IP (2013–23) Strategy 1B, p.12
  • Mainstream health services are supported to provide clinically competent, culturally safe, accessible, accountable and responsive services to Aboriginal and Torres Strait Islander peoples in a health system that is free of racism and inequality.
  • Guidance on the provision of clinically competent and culturally safe services (including MH) has been provided and implemented.
Cultural RF (2016–26) Domain 3, p.14
  • Budget and resources to support adequate cultural safety and responsiveness training of health staff at all levels (clinical and non-clinical) and across all disciplines, including ongoing professional development, capacity for self-reflection and monitoring of health staff skills
Domain 4 p15
  • Design and delivery of organisational performance measurement and evaluation of services including organisational self-assessments of cultural competency activities involves Aboriginal and Torres strait Islander health consumers
  • Aboriginal and Torres strait Islander consumers are engaged in performance measurement and evaluation of health services through accessible, culturally responsive and safe processes
Korin Korin Balit-Djak (2017–27) Strategic direction 3.1.1
  • Increase cultural capacity and cultural responsiveness
  • Over the next three years, the department will:
    • Develop a cultural safety framework to ensure we have a common approach to providing a culturally safe workplace. The framework will prioritise training for the department’s executive officers and senior management, local engagement officers, program service advisors, Standards and Regulation Unit and child protection staff and management. The cultural safety framework, its implementation and monitoring will be informed by Aboriginal staff and Aboriginal communities.
    • Monitor, evaluate and support mainstream services in partnership with Aboriginal organisations to increase cultural capacity and responsiveness, including working intensively with organisations that need to improve performance.
    • In partnership with the Aboriginal Children’s Forum, work with Aboriginal communities and organisations to review existing cultural competence requirements and assessment approaches across the health and human services sector. This will include community service organisations, ensuring that cultural competency requirements are assessed by Aboriginal people and organisations. These requirements will be embedded in the department’s policy and funding plan and funding and service agreements.
    • Review the ICAP program and CQI tools to ensure that they conform with Version 2 of the NSQHS Standards and the findings of Koolin Balit’s improving the cultural responsiveness of hospitals evaluation.
    • Support health services to implement Version 2 of the NSQHS Standards to meet the needs of Aboriginal clients by providing a culturally responsive service.
    • Have a better understanding of why Aboriginal people have high rates of ‘Take own leave’ (discharge from admitted care or did not wait for care in emergency or specialist clinic services) in Victorian health services and develop strategies to reduce premature discharge.
  • In 10 years, success will look like:
    • Aboriginal Victorians have access to culturally responsive health and human services across the continuum from prevention to tertiary care.
National Standards—MH Workforce (2013) Standard 4, p.14
  • By working with Aboriginal and Torres Strait Islander peoples, families and communities, MH practitioners actively and respectfully reduce barriers to access, provide culturally secure systems of care, and improve SEWB.
  • The MH practitioner:
    • Develops an understanding of Aboriginal and Torres Strait Islander history, and particularly the impact of colonisation on present day grief, loss and trauma and its complexity
    • Communicates in a culturally sensitive and respectful way, being aware of potential mistrust of government and other service providers as a result of past history
    • Implements culturally specific practices as described in relevant national, state and local guidelines, policies and frameworks that pertain to working with Aboriginal and Torres Strait Islander Respectfully collects and records information identifying Aboriginal and Torres Strait Islander status in line with current policy directives
    • Works in collaboration with Aboriginal and Torres Strait Islander cultural advisors where appropriate regarding appropriate care and engages meaningfully to develop culturally appropriate care in collaboration with these support networks
    • Seeks to understand and work within local cultural protocols and kinship structures of Aboriginal and Torres Strait Islander communities
    • Respectfully follows Indigenous protocols in community contexts, such as the process of vouching in which one or some of the community members attest to the person wishing to enter the community
Nat Standards – MH services (2013) Standard 4, p.12
  • 4.1 – The MHS identifies the diverse groups … (inc.) Aboriginal and Torres Strait Islander people… that access the service.
  • 4.2 – The MHS whenever possible utilises available and reliable data on identified diverse groups to document and regularly review the needs of its community and communicates this information to staff.
  • 4.3 – Planning and service implementation ensures differences and values of its community are recognised and incorporated as required.
  • 4.4 -The MHS has demonstrated knowledge of and engagement with other service providers or organisations with diversity expertise / programs relevant to the unique needs of its community.
  • 4.5 – Staff are trained to access information and resources to provide services that are appropriate to the diverse needs of its consumers.
Criterion 4.3
  • Aboriginal and Torres Strait Islander.20.
  • The MHS needs to demonstrate that staff can access cultural competency training in MH, and provide statistics on the percentage of staff who annually attend this training.
  • The MHS, where available and appropriate, should integrate the use of… Aboriginal and Torres Strait Islander liaison staff into service delivery.
  • The MHS should appoint cultural guides appropriate to their communities and who are accessible to all staff members.
  • Evidence includes
    • evidence of partnerships with the Aboriginal and Torres Strait Islander community
    • service level agreements with other providers such as Aboriginal and Torres Strait Islander medical services, divisions of general practice or Royal Flying Doctor Service
    • development of measures for cultural competency of staff
    • external monitoring of non-discriminatory practice by carers and consumers and Aboriginal and Torres Strait Islander community groups.
  • Implementation Guidelines for Private Office-based Mental Health Practices. p17. The MHS needs to demonstrate that staff are able to access cultural competency training in MH and provide documentation showing the percentage of staff who annually attend this training.  The MHS, when it is appropriate, should integrate the use of available culturally and linguistically diverse Aboriginal and Torres Strait Islander liaison staff into service delivery.
Standard 4.6, p.12
  • The MHS addresses issues associated with prejudice, bias and discrimination in regards to its own staff to ensure non-discriminatory practices and equitable access to services.

Trauma informed care

Policy document Reference Description
Fifth Plan (2017-23) Action 12.4. p.34
  • Training all staff delivering MH services to Aboriginal and Torres strait Islander peoples, particularly those in forensic settings, in trauma-informed care…
Korin Korin Balit-Djak (2017-27) Strategic direction 5.1.1, p.54
  • Promote and embed Aboriginal trauma-informed healing, recovery and resilience initiatives
  • Over the next three years, the department will:
    • Implement Balit Murrup: Aboriginal social and emotional wellbeing framework.
    • Support the delivery of more integrated seamless services across Aboriginal and mainstream primary and mental health, drug and alcohol, family violence, child and family, and justice services to improve social and emotional wellbeing responses across the promotion, prevention, early intervention, treatment and recovery continuum.
    • Resource the design and implementation of three demonstration projects aimed at improving mental health outcomes for Aboriginal people, families and communities. One project will focus on reducing the impact of parental mental illness where children are in child protection and another focussing on clients in the justice system.
    • Work with Aboriginal communities to inform the delivery of the place-based and suicide prevention trials being undertaken in 12 Victorian communities.
    • Establish new Aboriginal mental health traineeships based in mainstream services that will include support for the completion of a tertiary qualification in mental health-related disciplines.
    • Resource the establishment of clinical and therapeutic mental health positions within Aboriginal community-controlled organisations across rural, regional and metropolitan areas.
    • Partner with Aboriginal communities to co-design healing, grief and loss, trauma-informed and recovery approaches and tools delivered through Aboriginal and mainstream services. These will focus on trans generational trauma, children and young people in child protection and the justice system.
    • Consolidate and expand an evidence base for initiatives and approaches proven to be effective in strengthening Aboriginal resilience, healing, suicide prevention and recovery from mental illness.
  • In 10 years, success will look like:
    • Evidence-based, Aboriginal-led resilience building, healing and trauma-informed care and recovery approaches are embedded in primary and specialist social and emotional wellbeing and mental health responses. These will contribute to improved social and emotional wellbeing across Aboriginal communities with a reduction in the incidence and impacts of psychosocial distress, mental illness and suicide.
    • Aboriginal children and young people have access to culturally appropriate services and reduced levels of psychological distress.