Effective SEWB & Healing Programs

Aboriginal healing programs are at the forefront of dynamic cross-cultural and culturally responsive suicide and mental health interventions reflecting the diversity of Indigenous cultures and life-experiences within Australia (Dudgeon, Bray, Smallwood, Walker & Dalton 2019 in press). They include traditional healing, clinical and evidence-based suicide prevention healing programs many of which have been described in The Elder’s Report (2014) and Working Together book (Dudgeon, et al., 2014a), although only a few have been evaluated.

Key barriers to service provision in the Indigenous healing sector include:

  • inadequate funding and staffing, and
  • a lack of understanding of intergenerational trauma and the need for Indigenous healing among government and mainstream health workers (Healing Foundation, 2018).

Aboriginal and Torres Strait Islander peoples embrace a holistic concept of health, which links mental and physical health within a broader concept of SEWB. This concept recognises the interconnectedness of physical and mental health with spiritual and cultural factors and connection to the land, community and traditions as part of wellbeing.

The adverse and lasting impacts of colonisation has resulted in many people experiencing intergenerational trauma and social and economic disadvantage at individual, family and community levels. This can result in complex and interrelated issues and multiple stressors such as poor quality, overcrowded housing, poverty, trauma, abuse and loss placing unacceptable burden on Aboriginal and Torres Strait Islander people’s lives that can challenge their mental and physical health and wellbeing.

The SEWB concept recognises the importance of connection to land, culture, spirituality, ancestry, family and community, and how these can affect individual people. SEWB issues can result from unresolved grief and loss, trauma and abuse, domestic violence, removal from family, substance misuse, family breakdown, cultural dislocation, racism and discrimination and social disadvantage. (Social Health Reference Group, 2004, p 9).  Trauma, grief and loss as well as alcohol and substance use have been found to be key factors in suicide deaths.

The recent ATSISPEP Report (2016) findings confirm the need for:

Interventions focused on strengthening all domains of SEWB, including culturally based healing programs that connect people with cultural traditions

Early interventions to address alcohol and substance use

Prevention efforts that are evidence based, relevant and address the range of systemic issues that reduce people’s capacity to make positive choices to enhance their health, mental health and wellbeing

Greater focus on supporting and restoring protective factors, such as community connectedness, strengthening the individual and rebuilding family

Summary findings

Policy responses to promote SEWB need to be multidimensional and involve a wide range of stakeholders including families and communities, the health sector, housing, education, employment and economic development, family services, crime prevention and justice, and Aboriginal Community Controlled Health Services (ACCHS).

Strategies that build on the strengths, resilience and endurance within Indigenous communities and recognise the important historical and cultural diversity within communities are also recommended (SHRG, 2004).

The important role of healing programs and services to promote social and emotional wellbeing and suicide prevention was highlighted in The Elders Report into Preventing Indigenous Self-harm & Youth Suicide. The  Healing Foundation identifies three key areas which support positive healing outcomes:

  • Quality healing programs and initiatives led by communities and developed to address the local impacts of trauma
  • Healing networks, champions and organisations to promote healing at a national and community level, including trauma awareness and the importance of truth telling
  • A supportive policy environment where policy makers and influencers understand and advocate the benefits of Aboriginal and Torres Strait Islander healing and its long term nature. (Healing Foundation, A theory of change for healing 2019, p.6)

The programs and services included here address these elements.

Cultural, Social and Emotional Wellbeing Program

The National Empowerment Project (NEP), Cultural, Social and Emotional Wellbeing (CSEWB) Program has been developed and designed for Aboriginal and Torres Strait Islander people and communities across Australia based on extensive community consultation with eleven communities in response to high rates of psychological distress, self-harm and suicide.

The Cultural, Social and Emotional Wellbeing Program is currently being delivered at Langford Aboriginal Association 2019 – 2020.

Langford Aboriginal Association
15 Imber Turn, Langford WA 6147
Telephone: (08) 9451 1424
Email: admin@laalangford.com.au

The National Empowerment Project (NEP) involved the following stages:

  1. The completion of extensive community consultations and production with individual site reports with results and recommendations.
  2. The development of the CSEWB Program.
  3. The delivery of the CSEWB Program in the NEP community sites.1

The National Empowerment Project conducted consultations with 11 Aboriginal communities across Australia as a response to address the disproportionate (five times the rate of non-Aboriginal Australians) and an upward trend of Aboriginal suicides in Australia. Community Reference Groups (CRG) comprising of Aboriginal Elders, Aboriginal-led organisations as well as government agencies and not-for-profit organisations were engaged throughout the research and continue to be engaged during the program delivery. Those consultations2 identified a number of factors that contributed to poor mental health and social wellbeing in these Aboriginal communities including:

  • intergenerational trauma
  • effects of stolen generations
  • racism and discrimination
  • high levels of psychological distress
  • lateral violence
  • interpersonal conflict
  • domestic violence
  • unresolved grief and loss
  • high levels of unemployment, and
  • severe poverty.

The research findings confirmed that Aboriginal people and their families become vulnerable to exploitation and ready access to alcohol and or drug substances. An evaluation of the NEP confirmed the program was successful in facilitating an alternative approach to empowering Aboriginal people to enhance their cultural, social and emotional wellbeing and adopt healthier coping strategies as a consequence of multiple disadvantages.

The CSEWB program was developed in response to the NEP research findings and is a comprehensive structured program designed to promote the CSEWB of Aboriginal participants incorporating empowerment, healing and leadership, building resilience and giving people strength. The CSEWB program was initially implemented and evaluated in Kuranda and Cherbourg in Queensland in 2014 to 2016.3

In August 2017, the Perth community re-engaged in a NEP CSEWB workshop to re-establish their commitment to participating in the NEP CSEWB program. These consultations provided evidence of Aboriginal people’s values regarding their cultural strength and identity as well as the need for culturally appropriate programs.

Key stakeholders continue to support program implementation at the local level. The facilitators are Aboriginal people from the local region who are trained specifically to deliver the program. The Langford Aboriginal Association (LAA) in Western Australia is the lead organisation supporting the program delivery in the Perth region and was part of the initial research and has had ongoing involvement.

In 2017, Relationships Australia WA (RAWA) applied to the West Australian Primary Health Alliance (WAPHA) to fund the CSEWB program. RAWA engaged LAA to deliver the program at three identified sites in the Perth metropolitan area:

  • Balga, Girrawheen, Koondoola;
  • Kwinana and Rockingham;
  • Langford, Kelmscott and Gosnells.

In 2018-2019 the WAPHA refunded the program through LAA who in partnership with RAWA delivered the CSEWB program twice in Kwinana, with 46 graduates and in 2019-2020 the program has been re-funded to be delivered twice at Langford with 21 participants attending the first program.

The Cultural, Social and Emotional Wellbeing (CSEWB) Program aims to provide participants with strategies to:

  • promote their positive cultural, social and emotional wellbeing
  • strengthen their mental health of their families
  • build resilience, and
  • prevent psychological distress.

A Community Reference Group (CRG) provides direction to ensure the effective and culturally safe implementation of the CSEWB program. The CRG provides the overall cultural governance for the program managers and facilitators who implement the program. The CRG includes the membership of Elders, other Aboriginal community members and organisations providing health and social services to the local community.

The CSEWB Program is delivered over a three-month period with 12 culturally-secure, sessions once a week including a field trip and a graduation ceremony along with an opportunity for participants to implement a community project. The program is available to Aboriginal people over the age of 18 years as well as non-Aboriginal people who are well-known in the community and want to participate in the program. In Western Australia, for example, this is delivered through Langford Aboriginal Association in partnership with Relationships Australia WA.4

Over the course of the CSEWB program each participant explores concepts of self including their personal understanding of how the legacy of colonisation has affected their understanding of Aboriginal social history, loss of culture, family and parenting concepts, leadership styles, personal development and self-esteem and efficacy. These concepts are further explored through group discussions.

Program participants are given a task to complete that involves a cultural project within the community. This project is developed through the group who design, develop and implement the project using their existing skills and knowledge and new resources learned through the program.

Participants have reported improvements in their confidence, parenting, family life, a sense of belonging and wellbeing, capacity to cope with life events and understanding of their personal life histories. Other outcomes have been noted in regard to participants which are:

  • completing their first course post-high school
  • gaining employment
  • enrolling in further training or other courses
  • completing a bridging course to gain admission to university medical studies
  • increasing their confidence and wellbeing
  • reducing alcohol or drug use
  • increased confidence to take up new opportunities
  • engaging in a small business training to become a self-employed artist
  • becoming a Chairperson of an organisation, and
  • becoming a facilitator of the CSEWB.

After some of the group participants overcome their initial shyness they begin to learn from one another, support one another in their learning, form supportive bonds, accept one another and encourage each other to attend forthcoming group sessions. It is the collective support that has ensured ongoing attendance by participants. This contrasts with individual counselling approaches whereas anecdotally people may attend one or two sessions and then cease participating. The program can accommodate up to 20 participants at any one time in order to ensure participants are given maximum opportunity to engage in activities and discussion.

Participants demonstrated an increased appreciation and understanding of Aboriginal history and the cultural impacts and how it connects to the current circumstances of individual, families and communities. For some participants the program reinforced what they already knew and for others it was the first opportunity they had to become fully aware of the social and cultural impacts of colonisation on their lives as Aboriginal people. This created a better understanding of connection to country and the role that Elders play through the cultural sessions and activities. There was also a new-found appreciation of Elders and how important they are in maintaining and creating cultural understanding. Participants developed a better understanding of ways in which they can utilise their knowledge to continue to make positive changes in their own lives.

Evidence from evaluations undertaken for two sites in Queensland2/3 and more recently for the programs delivered at three sites in WA strongly supports the intended outcomes being achieved. The evidence is based on observations of participants and feedback gathered over the duration of the program which includes a pre- and post-evaluation and Stories of Most Significant Change (MSC)2. The MSC is seen as being a culturally-safe way of gaining qualitative data. This data has been analysed within the individual evaluations of program delivery over the program implementation time in Western Australia and in Queensland.

The program administers the Kessler Psychological Distress Scale5 (K5) psychological assessment tool for each participant at the commencement of the program in order to identify participants who may require initial or ongoing support during their participation.

Evaluations6/7 of the program have indicated that the participants have:

  • increased their confidence so that they are able to seek employment and become employed
  • improved relationships with their children, partners and extended family and community including the prevalence of family violence
  • increased knowledge about Aboriginal history
  • a better understanding of the impacts of intergenerational trauma and therefore an increased understanding of determinants impacting on their own lives
  • a better ability to speak up for themselves and therefore becoming empowered, and
  • developed strategies to cope with their grief and loss around suicide, poverty, mental illness and deaths impacting on themselves, their families and communities.

A project evaluation of the NEP was conducted to determine how effective the NEP was in achieving its stated goals. The evaluation report8 summarises the development and implementation of the CSEWB Program in the communities of Kuranda and Cherbourg between 2014-16. A further evaluation3 focusing on specific outcomes and impacts of the CSEWB Program was undertaken in 2017 with participants from Kuranda and Cherbourg. The evaluation findings were based on an analysis of:

  • current interview outcomes
  • information summarised from the Stories of Most Significant Change (written after participants complete the Program), and
  • the original data from the 2013 NEP consultations.

The evaluation6 identified the following eight themes:

1. Personal Strengths:

Participants reported increased self-awareness and self-esteem, improved confidence and more assertiveness in achieving set goals.

They acknowledged their own development of individual strengths, including public speaking skills and the ability to voice their own opinions and viewpoints in family and community discussions, business settings, and other situations.

2. Healthcare and Healthier Lifestyle Choices:

Participants reported an increased understanding of, and commitment to, their own health and wellbeing, and that of their children and families. This extends further to also be inclusive of the collective community’s overall health and wellbeing.

3. Relationships: Children, Partners, Family, and Community:

Participants voiced their increased knowledge and resolve around the importance of nurturing more positive relationships with their family members and the wider community. This resulted in a stronger commitment to reconcile in more positive ways that do not impinge on individual self-esteem and health.

4. Family/Domestic Violence and Incarceration:

There was increased awareness and networking support for participants where they shared a range of issues affecting their and their families’ wellbeing.

5. Life Skills and Life Planning:

Participants reported an increased awareness and development of skills to change situations and develop confidence. They reported a stronger understanding of the benefits of positive self-talk, and how this can dispel negative self-talk (bad thoughts, old negative habits/behaviours, aggressive actions and language) towards oneself, family members, and others.

6. Education, Training, and Employment:

Personal and professional development was seen as a positive aspect of the Program. Pursing higher education and training assists in individual growth, assertiveness, attaining a better life, and economic stability and sustainability for participants and their families.

7. Cultural, Social, and Emotional Wellbeing:

Participants reported a strengthened sense of identity, including cultural identity specifically. Completing the Program and undertaking a self-assessment of their progress via Stories of Most Significant Change enabled participants to better understand the series of success factors that aided their achievements over the duration of the Program.

8. Cultural Reconnection, Identity, Pride, and Community:

There was a renewed focus of the importance of reconnecting with country and culture. The positive benefits of feeling a sense of belonging, and family and community unity were also highlighted.

On an individual basis, participants identified positive outcomes in their physical and mental health and general wellbeing, enabling participants to focus on their personal and family’s needs in a more positive and constructive way, strengthening family and community relationships. Participants identified the value of strengthening culture and spirituality, which extends to self, family, others, all living things, and the natural world. A crucial outcome for participants was the realisation or affirmation around how everything is connected within a cultural context, and how this can bring a sense of inspiration, connectedness, and hope for individuals, families, and the wider community.

The findings of the evaluation are especially significant acknowledging the importance of ‘going back to country’ for cultural purposes, and for family and community reconnection to the land, and cultural ceremony. Participants reported being more confident and empowered after completing the CSEWB Program. The value of the CSEWB Program has been demonstrated throughout the evaluations that have been undertaken following each program delivery. This has been through direct statements and feedback from Program participants regarding their own positive experiences and journeys. Participants who completed the Program reported feeling a greater sense of wellbeing, greater resilience, and increased capacity to address and resolve many of the issues impacting on them, their families, and their communities. Participants have attained skills and knowledge that will assist them to succeed in a range of ways that have only been realised since participating in the empowering Program.

1. National Empowerment Project. Relationships WA.Duffin, W, Riley, B, Grogan, G, Butorac, A, Cox, A, Dudgeon, P & Swift, S. 2013,

2. The National Empowerment Project Kuranda. The University of Western Australia: Crawley Western Australia.

3. Mia, T., Dudgeon, P., Mascall, C, Grogan, G, Murray, B., Walker, R. 2017, An Evaluation of the National Empowerment Project Cultural, Social, and Emotional Wellbeing Program, Special issue of Indigenous Suicide Prevention, Te Mauri Pimatisiwin. Volume 2, Issue 2, Article 3 pp 33-48

4. Cultural Social and Emotional Wellbeing Program. Langford Aboriginal Association. 2020.

5. Jorm, A, Bourchier, S, Cvetkovski, S & Stewart, G. 2012. Mental health of Indigenous Australians: a review of findings from community surveys. The Medical Journal of Australia. Issue 196, pp 118 – 121

6. Perth Evaluation Report September 2018. WA Primary Health Alliance and Primary Health Network WA.

7. Perth Evaluation Report September 2019. WA Primary Health Alliance and Primary Health Network WA.

8. Mia, T & Oxenham, D. 2017. National Empowerment Project Cultural, Social, and Emotional Wellbeing Program Evaluation 2014 – 2017. The University of Western Australia: Crawley, WA.

Further reading at The National Empowerment Program website. https://www.nationalempowermentproject.org.au/publications

Dudgeon, P, Cox, K, D’Anna, D, Dunkley, C, Hams, K, Kelly, K, Scrine, C & Walker, R. 2012, Hear Our Voices: Community Consultations for the Development of an Empowerment, Healing and Leadership Program for Aboriginal people living in the Kimberley, Western Australia – Final Research Report. Commonwealth of Australia: Canberra.

Dudgeon, P, Walker, R, Scrine, C, Dunkley, C, D’Anna, D & Cox, K. 2012, Developing an Innovative, Culturally Responsive Healing, Empowerment and Leadership Program for Aboriginal People Living in the Kimberley Region of Western Australia. Research and Policy Brief. Department of Health and Ageing, Telethon Institute of Child Health Research: Perth, WA.

Mia, T. (2017). National Empowerment Project Cultural Social Emotional Wellbeing Program Evaluation 2014-2017. Sister Kate’s Home Kids Aboriginal Corporation.

Oxenham., D. (2017). The National Empowerment Project Phase Three Evaluation Report. (2014-2016).

Family Wellbeing Program (National)

The Family Wellbeing Program aims to empower individuals, families and communities by developing analytical and problem-solving skills to address life’s challenges.

The Family Wellbeing Program: Empowerment Research

Contact:
Phone:
03 8341 5555/Email: General enquiries – admin@lowitja.org.au
Research enquiriesresearch.enquiries@lowitja.org.au

The Family Wellbeing Program (FWP) is a Certificate II course, offered by trained facilitators, and which focuses on the empowerment and personal development of Aboriginal and Torres Strait Islander (hereon Aboriginal)  people through the sharing of stories, discussing relationships and setting future goals. The survival experiences of course facilitators and participants are the program’s main learning resources. Workshops are held for both adults and children to highlight the various health and social wellbeing issues experienced by Aboriginal communities and the steps that can be implemented to deal with them.

The FWP takes a community development approach to address health and the social determinants impacting on health across the continuum of care and is a framework for social and emotional wellbeing (SEWB). Group processes play an important role in facilitating a safe and supportive learning environment in which participants feel comfortable to reflect and express feelings. The FWP articulates the human qualities necessary for leadership and healthy relationships such as vision, respect, empathy, and compassion. It advocates relationships that are based on wisdom, acceptance, freedom and honesty, and provides a safe forum for reflection and learning skills to achieve these personal qualities and relationships.

The FWP was initiated in South Australia in 1998 by a group of Aboriginal people affected by the Stolen Generations policies and practices. The Apunipima Cape York Health Council in Far North Queensland has modified the program to meet the specific needs of the local communities of Hopevale and Wujal Wujal.  The FWP has also engaged in sustainability efforts by expanding the number of organisations that are certified to deliver this Certificate II program. In November 2014, the program extended to New South Wales after facilitators from the Griffith Aboriginal Medical Service were trained in its delivery. In 2016, the FWP was delivered in Mildura through the Mallee District Aboriginal Services whilst in 2017, the FWP was first offered in Western Australia (WA) at four locations (Perth, Roebourne, Geraldton and Bunbury) by the Aboriginal Health Council of WA. The program has also been successfully delivered in China where the founder ran workshops at the Shenyang University of Chemical Technology. Subsequently teachers there have engaged in teaching and researching in the area of family wellbeing1.

The Family Wellbeing Program seeks to:

  • Engage and support individuals and groups in Aboriginal communities to take greater control and responsibility for their health and wellbeing
  • Provide a safe and supportive learning environment and an opportunity for people to reflect on and share stories about important questions for life: Where am I going with my life? Who is benefiting and who is losing out? What can I do to change the situation? What would be the consequences?
  • Foster the empowerment and personal development of Aboriginal people through discussing relationships, and identifying goals for the future
  • Address the health and social issues experienced by Aboriginal communities and formulate steps that can be implemented
  • Provide an ‘inside-out solution’ that builds on Aboriginal strengths

This comprehensive program facilitates empowerment at personal, family, group and community levels. It develops the ability to identify and address systemic level issues and thereby provides greater opportunities for participants and their communities to:

  • Facilitate Aboriginal people’s empowerment and capacity to regain SEWB
  • Rebuild the cultural and social norms of their families and community
  • Address issues such as family violence and abuse, suicide and incarceration
  • Take greater charge of issues affecting their health and wellbeing, give and demand more in their relationships, and participate more actively
  • Analyse situations more carefully
  • Improve skills to break new ground in areas such as values-based Aboriginal workforce development and organisational change
  • Share stories and explore issues regarding contemporary Aboriginal spirituality

An extensive evaluation by the University of Queensland and James Cook University in 20062 demonstrated the effectiveness of the FWP empowerment approach as a tool for engaging participants on a wide range of issues affecting their health and wellbeing and those of their families.

Participants’ reported an enhanced sense of self-worth, resilience, problem-solving ability, and ability to address immediate family difficulties and to change their social environment; and a greater capacity to address wider structural issues such as poor school attendance rates, a critical housing shortage, endemic family violence, alcohol and drug misuse, chronic disease, and over-representation of Aboriginal men in the criminal justice system.

In 2018, a comprehensive evaluation3 summarised the key findings of several publications about self-reported qualitative and quantitative evaluations of FWP. These papers reflect the achievements of various program outputs including training FWP facilitators and producing research publications, and program level outcomes such as improvements in individual health and outcomes beyond the project level. This reflects the achievement of the program through tangible evaluations. The FWP has prolific outputs and evaluations which consistently demonstrate that it addresses the current needs of the communities it serves. These characteristics confirm the effectiveness and cultural appropriateness of the program in achieving its goals and documented uptake across Australia and beyond. The program is being increasingly incorporated into a range of health interventions, workforce training programs and school curricula.

The Family Wellbeing Program:

  • Builds strengths and capacity in Aboriginal and Torres Strait Islander communities and resilience in individuals and families
  • Improves the capacity of communities to initiate, plan, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans
  • Provides materials and resources appropriate for the needs of Aboriginal peoples in diverse community settings
  • Identifies high levels of suicide and self-harm in communities and facilitate a planned response
  • Provides culturally appropriate community activities that engage youth, builds cultural strengths, leadership, life skills and social competencies through the on-country trips, resulting in life promotion and resilience-building
  • Is founded on long-term, sustainable prevention strategies that build resilience and promote SEWB
  • Builds an evidence-base and strong standards in suicide prevention through the development of a locally accessible capacity to monitor risk behaviours and indicators of functioning for individual communities and regions in order to reduce suicidal behaviour and prevent suicide.
  • Provides consistent evaluations of its programs to find ways to improve their effectiveness in meeting the needs of Aboriginal communities
  • Develops and supports Aboriginal peoples in the suicide prevention and wellbeing workforce
  • Develops high standards for community engagement and cultural awareness in wellbeing and early intervention services.
  • Is one of Australia’s pre-eminent empowerment, healing and SEWB programs whose effectiveness and responsiveness has been clearly demonstrated over many years and through a rigorous and comprehensive evaluation process.

The review team rated the FWP very highly as strong evidence of effectiveness and best practice. It is an example of the impact of a sustainable and longer-term program and of the critical importance of empowerment to achieving SEWB.

    1. Family Wellbeing Newsletter, Issue 5, November 2017 [Available at https://www.cairnsinstitute.jcu.edu.au/fwb-newsletter/.
    2. Pearson KT. Evaluation Report 2006 [Available at https://www.researchgate.net/profile/Komla_Tsey/publication/242484452_Evaluation_Report_2006/links/02e7e52d47979179d1000000/Evaluation-Report-2006.pdf .
    3. Onnis L-A, Klieve H, Tsey K. The evidence needed to demonstrate impact: a synthesis of the evidence from a phased social and emotional wellbeing intervention. Evaluation and Program Planning 2018; 70:35-43 [Available at https://www.sciencedirect.com/science/article/abs/pii/S0149718917302872 .

Kalka Healing: Healing starts with you (NT)

Kalka Healing is an Indigenous led and developed suicide prevention program which provides workshops which are practical, at the grassroots level, and culturally sensitive.

https://kalkahealing.com.au/#purpose

Contact:

Mobile: Cleavon Davis (Director), 0423512993    Email: info@kalkahealing.com.au

Cleavon is a proud Aboriginal man from Mount Isa and an experienced and qualified counsellor with over ten years experience in providing social and emotional well-being counselling to Aboriginal and Torres Strait Islander people (hereon Aboriginal). For a long time, he has seen suicide as a devastating issue for Aboriginal people across Australia. Hence, Cleavon has compiled his knowledge, skills and sourced materials to develop workshops which lead to healing and empowerment for participants and their communities.

This Kalka Healing provides training which specifically addresses Aboriginal suicide prevention by providing tools for coping as an individual and responding to suicide in the community. Aboriginal people aged 14 years and older may participate. Further, non-Aboriginal people who want to better understand suicide in Aboriginal people may also attend.   Importantly, the workshops are practical, at the grassroots level, and culturally sensitive.

Kalka Healing is wholly owned by Aboriginal people and the workshops are delivered by a qualified and experienced Aboriginal Social and Emotional Wellbeing Counsellor at a local level to ensure relevance to individual communities.

Training offered include a 14-hour suicide prevention, coping and response training program entitled Healing starts with you. Here, participants are supported to create a local prevention strategy. This is done by recording a detailed list of what best addresses the participants’ needs, community needs and the needs of families within that community. Participants are guided to respond and cope with their own suicidal thoughts, feelings of worthlessness and the associated pain.   Participants are also guided to build a local and culturally appropriate strategy, designed to empower their community.

The second training session, Passport for life, is a four-hour workshop which is aimed at preventing suicide in at-risk youth. Here, safety plans are developed with young people. These plans aim to provide tools for young people to deal with uncontrolled thoughts by identifying and connecting with their community as well as to identify support networks and safe places.

This workshop is designed to support young people to create individualised safety plans that help to divert risks of harm and suicide ideation. By creating a Passport for Life, young people are guided to identify and connect with support from their families, schools, communities and professionals.

Our overarching goals are to reduce suicide in Aboriginal people by:

  • Providing participants with the tools to lead a purposeful life while being connected to country, culture, community and family
  • Enabling participants to turn away from suicide ideation and to grow more resilient
  • Teaching communities to respond pro-actively to suicide, suicide attempts, suicide ideation and self-harm

Kalka Healing works towards the achievement of these goals through the following objectives within their programs, Healing starts with you and Passport for life by: The

  • Showing participants how thoughts determine behaviour and how negative thoughts can lead to suicide ideation and/or suicidal attempts
  • Teaching participants to identify and control negative thoughts and to turn them into positive ones
  • Overcoming the sensitivities of Aboriginal people towards discussing suicide by providing support, involvement and education
  • Providing a Healing Circle
  • Strengthening culture and building confidence in participants
  • Addressing participants in a culturally appropriate language and culturally safe manner
  • Enabling participants to identify signs of an impending suicide attempt and to respond appropriately
  • Providing support to those bereaved by suicide
  • Providing individuals, families, groups and communities with culturally appropriate and culturally safe prevention strategies that action resilience against suicide
  • Building a customised suicide prevention strategy responding to local needs

Workshop participants and their communities are provided with the means to develop a customised Suicide Prevention Plan that best fits themselves and their community. Participants are provided with the means to identify and control negative thoughts and to turn them into positive ones and to better identify with country, culture, community and family. Furthermore, participants are better able to provide support to those bereaved by suicide.  In these ways, healthier-minded individuals emerged, and communities are empowered to manage the customised strategies created in the workshops.

This training program has not yet been formally evaluated. However, by community invitation, evaluation of the developed strategy proceeds three-months after the delivery of Healing starts with you. In these instances, Cleavon revisits the community and runs an additional workshop which guides participants to reflect on what has worked well, what has not, and what they would like to do differently. As required, additional information is provided for the group to move forward towards their goals. At the end of the workshops, Cleavon collects feedback forms from participants. These will enable him to  continue to improve the workshops and also to monitor the success of the strategies developed and the extent to which people report feeling more empowered and positive about the future. To date feedback received points towards the success of Kalka Healing. Former participants reported better coping, feeling more positive and more able to express their feelings while some reported no longer feeling suicidal. In addition, participants expressed that the program reduced the stigma of talking about issues associated with suicide and affirmed the importance of culture, family and community. A key indicator of the effectiveness of Kalka Healing and the developed strategies is that participants acknowledged that it is their strategy, developed upwards from the grass roots level.

Promising program, assessment pending.

National Empowerment Project (WA)

The National Empowerment Project (NEP) is an Indigenous-led empowerment project that promotes positive social and emotional wellbeing and addresses social determinants of health using a Participatory Action Research approach (PAR).

Phone: (08) 6488 6925

The National Empowerment Project (NEP) is an Aboriginal-led community empowerment project that works with Aboriginal and Torres Strait Islander communities to develop, deliver and evaluate programs that work to promote positive social and emotional wellbeing (SEWB) and address social determinants of health and reduce suicide. Using Participatory Action Research (PAR) the NEP engaged 8 Indigenous communities across Australia in 2012 – 13, and a further 3 sites in 2013-2014, to identify:

  • Risk and protective factors influencing mental health and SEWB of these communities
  • Develop strategies to respond to these issues through a focus on individuals, families and communities, using the SEWB framework (Social Health Reference Group, 2004; Gee et al., 2014)

The NEP evolved from the Kimberley Empowerment, Healing and Leadership Project in 2012, which identified the need for programs in Indigenous communities that build on cultural strengths, work towards healing at an individual, family, and community level and facilitate active community leadership to address the broader issues that impact on community wellbeing and are precursors to suicide (Cox et al 2014).

With the dual aims to increase resilience and reduce the instances of psychological distress and suicide among Indigenous peoples by the promotion of positive SEWB factors, and the empowerment of communities to take affirmative action to address the social determinants that contribute to psychological distress, suicide and self-harm. This was carried out with strong Aboriginal governance using a community-led and community-based model (Cox et al., 2014; Dudgeon et al., 2014).

The key objectives of the NEP program in two phases are to:
Phase one aims to:

  • Identify the main challenges impacting the SEWB of individuals, families, and the community along with strategies to strengthen cultural, social and emotional wellbeing to build resilience in facing these challenges through extensive community consultations
  • Conduct a two-day workshop to strengthen the cultural, social and emotional wellbeing for community members by identifying strengths within each SEWB domain, as well as actions to take to increase their connection to these protective factors

Phase two aims to:

  • Design and deliver the Cultural, Social and Emotional Wellbeing Program (CSEWB) to implement the community identified strategies to strengthen SEWB, to address the social determinants, as well as SEWB problems that exist in the community such as family violence and substance abuse
  • Assist communities to secure funds to implement the program(s) (Cox et al., 2014; Dudgeon et al., 2014)

As the NEP was developed, key stages included:

  • A NEP National Advisory Committee was established, comprised of leading Indigenous experts in mental health, suicide prevention and SEWB to ensure that Indigenous communities have an equal and empowered position within the research. The National Advisory Committee oversaw all aspects of the work of the NEP team, including the securing of Ethics approval for the project
  • A CRG was formed to guide and assist the implementation of the program, strengthen community ownership, and avoid program duplication. The CRG consisted of senior representatives from each community, the main family groups, relevant service providers and key stakeholders who share the goals of the program
  • The NEP team established strong relationships with community members and formal relationships with Aboriginal partner organisations in each community and maintained ongoing liaison and engagement with community stakeholders
  • Community consultants were employed as co-researchers in each community and provide training and support through the NEP team to conduct community consultations in each site that involve focus groups and interviews (Cox et al., 2014; Dudgeon et al., 2014)

This process of community consultations took place in eleven diverse communities across Australia. While these communities differed widely, they all had a significant Indigenous population, a readiness to engage in community capacity building and the ability to undertake a community consultation and deliver a short program. Other requirements included the presence of a functional community controlled organisation and/or a Registered Training Organisation (Dudgeon et al., 2014). The NEP sites by State or Territory are as follows:

  • Western Australia: Geraldton, Narrogin, Northam/Toodyay, Perth
  • Northern Territory: Darwin
  • Queensland: Cherbourg, Kuranda
  • New South Wales: Toomelah, Sydney/Redfern
  • Victoria: Mildura
  • South Australia: Mt Gambier

The independent process and outcome evaluations by Walker & Scrine was undertaken to determine the extent to which:

  • The key deliverables of STAR and Phase Two have been met
  • The recommendations from previous evaluations have been implemented
  • The key principles underpinning NEP have been successfully enacted
  • The effectiveness and impact of STAR and any identified gaps/areas for improvement
  • The outcomes of the key deliverables of Phase Two were evident (Walker & Scrine, 2014, p. 20)

An independent process evaluation of NEP was undertaken in 2014 by Walker & Scrine, which sought to determine whether the stated aims and objectives of the program were met in agreement with evidence-based and culturally informed consultation and development including the Support, Training, Advocacy and Research (STAR) component. A further evaluation of the program was done in 2017 (Dudgeon, Scrine, Cox, & Walker, 2017). The stories of most significant change as a way to capture the quality of importance in a survey and many interviews were used to inform the evaluation.

A 2017 evaluation highlighted similar grounds of the complex interrelationship between the cultural, social, economic, political and historical determinants impacting on Aboriginal and Torres Strait Islander peoples. Specifically, the 2017 evaluation focused on the CSEWB Program’s implementation between 2014 and 2016. The evaluation examined the following themes:

  • Personal strengths
  • Healthcare and healthier lifestyle choices
  • Relationships – children, partners, family, and community
  • Family/domestic violence and incarceration
  • Life skills and life planning
  • Education, training and employment
  • Cultural, social and emotional wellbeing
  • Cultural reconnection, identity, pride and community (Dudgeon, Scrine, Cox, & Walker, 2017)

Evaluation Findings
Key findings of the Walker & Scrine (2015) evaluation included:

  • The importance of community-based research with Aboriginal and Torres Strait Islander people leading the direction, development, implementation and accountability of strategies in their own communities. Capacity building and support, training and ongoing mentoring is a critical factor in this aim
  • The NEP community consultations have produced a large amount of data about issues around impacts on Indigenous mental health and wellbeing contributing to the evidence base regarding both the effect of adopting a CPAR research approach as empowering and the importance and effectiveness of community-based programs aimed at improving Indigenous mental health and SEWB
  • The critical need for continuing the STAR approach for the community co-researchers who work in communities experiencing high levels of trauma and distress. The support of the NEP team was highly advantageous and provided co-researchers with an ability to share their stories and debrief, and support each other in their roles as NEP researchers and frontline personnel involved in suicide prevention
  • The NEP reports crystallised the findings for communities including an overview of the identified issues in their communities, as well as plans to move forward
  • Formalised processes for communication and dissemination at each site with relevant agencies greatly assisted the effective response of these agencies to community needs
  • The STAR concept has great potential to assist NEP in achieving its goal
  • The support of partner organisations is a critical determining factor in the effectiveness of the community consultants and the ongoing progress of NEP (Walker & Scrine, 2014)

Key findings of the Dudgeon, Scrine, Cox, & Walker, 2017 evaluation showed that after the CSEWB program, participants:

  • Increased confidence, individual assertiveness and strengths in areas such as public speaking and voicing their opinions in discussions in various settings
  • Became more conscious of their physical and mental health. Participants noted decreased use of substances such as cigarettes, alcohol and marijuana and noticing how those physical changes improved mental health
  • Increased awareness and resolve to nurture more positive relationships with their children, partners, family members and the wider community
  • Learned skills to deal with family/domestic violence and family breakdown
  • Became more self-aware, recognising negative self-talk and its negative impacts on their behaviours. The program allowed participants to self-assess their behaviours and actions, and develop strategies to change their current lifestyles and situations
  • Developed a renewed interest in education and training and the associated benefits of personal and professional development for individual growth
  • Recognised the importance of reconnecting with their family, community, history, culture and country and how doing so provided a sense of belonging and enhanced cultural, social and emotional wellbeing
  • Recognised the value of strengthening culture and spirituality in bringing a sense of inspiration, connectedness and hope for individuals, families and the collective community (Dudgeon, Scrine, Cox, & Walker, 2017)

Recommendations for Phase Three:

  • To undertake in-depth qualitative research to understand the long-term impact of the NEP on peoples’ lives in order to further demonstrate over time the links between the underlying principles (such as: supporting self-determination, promoting context-specific solutions, incorporating Aboriginal knowledges and concepts regarding health and wellbeing, and acknowledging the pivotal role of family and culture) in developing and implementing programs that facilitate community transformation and empowerment (Walker & Scrine, 2014, p. 9)

The NEP builds strengths and capacity in Aboriginal and Torres Strait Islander communities and resilience in individuals and families. Specifically, it promotes communities to have the capacity to initiate, plan, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans. It provides materials and resources appropriate for the needs of Aboriginal and Torres Strait Islander peoples in diverse community settings. The project also identifies high levels of suicide and self-harm in communities and facilitate a planned response. In addition to prevention, the NEP  provides postvention responses to support individuals and families affected by suicide. They provide culturally appropriate community activities that engage youth, build cultural strengths, leadership, life skills and social competencies, resulting in life promotion and resilience-building. The activity is founded on long-term, sustainable prevention strategies that builds resilience and promotes social and emotional wellbeing, specifically, developed for Aboriginal and Torres Strait Islander families and children.

NEP  provides access to effective strategies to target suicide prevention through targeted and specialist services by all Aboriginal and Torres Strait Islander peoples who are at risk of suicide or self-harm, links and partnerships between mainstream specialist mental health and wellbeing services, Aboriginal and Torres Strait Islander wellbeing services and community organisations. NEP also  provides access to integrated and collaborative approaches across sectors responding to Aboriginal and Torres Strait Islander peoples who are at high risk, such as people experiencing mental illness, substance misuse, incarceration, domestic violence, etc. They have coordinated approaches to prevention through governance and infrastructure to support regional and local coordination of suicide prevention through improved community sector capacity and partnerships between services, agencies and communities.

Furthermore, the NEP has a strong evidence base for its work and provides clear standards and quality in suicide prevention. They provide locally accessible capacity to monitor risk behaviours and indicators of community functioning for individual communities and regions in order to reduce suicidal behaviour and prevent suicide. Their research is led by Aboriginal and Torres Strait Islander researchers to build an improved evidence base on the effectiveness of suicide prevention activity, including effective services and interventions, community initiatives, mental health awareness promotion and training and capacity development. They also have partnerships between researchers, Aboriginal and Torres Strait Islander communities and community organisations to evaluate evidence-based practices and provide support for program implementation and quality improvement. To establish standards and quality, they have comprehensive plans to develop and support Indigenous participation in suicide prevention and wellbeing workforce with a focus on early intervention into systems of quality improvement for social and emotional wellbeing and mental health care. It was rated very highly as strong evidence of effectiveness and best practice. Its community consultation and engagement, planning, implementation, community evaluation and feedback processes align strongly with the guiding principles underpinning the CBPATSISP Evaluation Framework. It aims to increase community capacity by supporting local-based programs that have been consulted and approved by stakeholders in the community. The program is also regularly evaluated to determine the efficacy of the program and provide recommendations towards suicide prevention.

Red Dust Healing (NSW/QLD)

Red Dust Healing is an Aboriginal cultural healing program. It was initially focused on Aboriginal male offenders and those at risk of offending. Currently, it is also delivered directly in response to community suicide and self-harm, as well as addressing the precursors of suicide such as alcohol and substance misuse, incarceration, family violence and poor wellbeing.

The founder, Tom Powell is a proud Warramunga man who grew up in the town of Narromine in the central west of NSW. For fourteen years, he was an Aboriginal Program Officer for the NSW Department of Juvenile Justice. Tom moved on and began his work developing Red Dust Healing1.

Website: https://reddust.org.au/

Contacts: Tom Powell, Sascha Costigan
Mobile: 0419 489 275 Emails: tom@thereddust.com; Sasch.Costigan@gmail.com

Red Dust Healing was originally designed in response to issues within the contemporary juvenile justice system. Tom identified a model of oppression within the system by the removal of the four core values of identity, responsibility, relationships and spirituality from Aboriginal and Torres Strait Islander (hereafter abbreviated as Aboriginal) people. The program addresses this oppression in ways that seek to reverse the colonisation process in terms of an individual’s self-image, their roles and responsibilities and their actions. The program offers an innovative approach to assisting men and women to heal and make better choices for themselves. Like other contemporary Aboriginal healing programs, Red Dust Healing explores the role of history and the associated trauma and invokes Aboriginal culture and spirituality as the core elements of the therapeutic process in an individual’s transformative journey.

Tom describes Red Dust Healing as a:
self-evaluating awareness program coming from an ancient Aboriginal perspective that gives individuals tools that empower them to be part of their own solutions.

Program personnel have delivered the program directly in response to community suicide and self-harm, as well as addressing the precursors of suicide such as alcohol and substance misuse, incarceration, family violence and poor wellbeing.

In addition to delivering the program in communities, the organisation trains former program participants to become community workers. After training, these workers receive the intellectual property rights to deliver the program within their community whilst emphasising the program’s aim to empower local communities and provide sustainability to the work of Red Dust Healing.

Red Dust Healing examines the intergenerational effects of colonisation on the mental, physical, and spiritual wellbeing of Aboriginal people and families and directly addresses the determinants of wellbeing. In particular, many Aboriginal men lost their identity, responsibility and relationships through colonisation2.   In response, this program targets Aboriginal males in recognition of the disproportionately high suicide rate among this group due to their heavy load of oppression and loss. Because of the authority of the father figure in Aboriginal culture, addressing the high suicide rates of Aboriginal males encourages the establishment of  family harmony.

This program provides a culturally safe environment, mechanisms for healing, a shared discourse, along with language and tools to enable participants to gain a sense of understanding and control in their lives. The program also encourages individuals to confront and deal strategically with the impact of rejection, hurt and anger in their lives and to understand that rejection is the foundation of all hurt. Participants examine their hurt and rejection and reflect on how this is manifested in their actions towards the people around them. Participants are also encouraged to examine their own personal hurt in order to heal themselves. This is seen as the first step in addressing the hurt they inflict on others within their personal relationships, their family and the overall patterns of violence and abuse in their lives.

Participants engage with contemporary forms of Aboriginal knowledge and reconnect with aspects of culture in order to strengthen their sense of self and their Aboriginal identity. This reorients participants to a new meaningful existence. Cultural knowledge is seen as a mechanism for Aboriginal people to understand their actions, their work and how to live their lives. Although the main target of the program is Aboriginal people, the program will also assist non-Aboriginal people. Red Dust Healing emphasises the importance of personal responsibility for making the best possible choices as essential to the healing process, an individual’s transformation and the generation of self-respect and meaningful connections to others.

The design of the program acknowledges the need to approach the healing journey in an individualised and personalised manner so that participants can apply their new tools and knowledge to their own circumstances. This is done using narratives from an individual’s life and encouraging them to reflect on their own situation whilst applying the program’s messages.

Red Dust Healing promotes an individual’s empowerment to find their own solutions. A tool has been developed called POUCH which is a solution-based, problem solving concept allowing participants to deal with issues in their own lives.  The name, POUCH is an acronym for identifying what Problems U have, what Options U have, what Choices U have and How U are going to deal with them.  Discussing this tool encourages participants to look at solving some of their concerns and gives them the responsibility without blame.

The main objectives of Red Dust Healing are to:

  • Restore the role of Aboriginal men in their families and communities by providing an understanding of rejection and an avenue for healing
  • Provide Aboriginal people with an understanding of identity to equip them with self-evaluation skills, to develop future role models for fathers, and to restore family relationships
  • Equip Aboriginal people with the tools to confront problems relevant to their lives
  • Address ongoing patterns of negative behaviour

More than 15,000 people from almost 300 communities have now completed different stages of the program3.  Outcomes include:

  • Improved understanding of the impact of rejection, grief and loss, along with the impacts of colonialism and oppression along with the tools to overcome those impacts
  • Restoring broken relationships and the strengthening existing ones
  • Better understanding of self and the opportunity to address the hurt within their lives
  • Improved self-esteem
  • The ability to identify the links between emotions with behaviours and actions
  • The ability to identify pathways for their families to access relevant service providers
  • Increasing the capacity of Aboriginal men to contribute, plan, implement and evaluate a variety of strategies, projects and programs in their community4

In 2017 and 2018, Red Dust Healing was recognised nationally by the receipt of two awards. The first was the United Nations of Australia Award for services to human rights and the second, the Mental Health Matters Award in the category of Aboriginal Social and Emotional Wellbeing awarded by the Mental Health Association of NSW.

Caritas Australia undertook a formal evaluation of this project in 20185 using a mixed method approach while being primarily qualitative in nature. The qualitative evaluation used a participatory method, including semi-structured interviews which optimized the role of stakeholders in the evaluation process. Interviews were conducted with participants and the evaluators deduced that participants had an improved understanding of the impact of rejection, grief and loss, along with the impacts of colonialism and oppression and the learning tools to circumvent these hurdles. Other findings were improved self-esteem, the restoring broken relationships and strengthening existing ones. At a community level, families were connected to service providers and the capacity of Aboriginal men to contribute, plan, implement and evaluate a variety of strategies, projects and programs in their community increased5.

In a meta-evaluation of programs for Aboriginal healing and suicide prevention, Red Dust Healing was rated very highly as strong evidence of effectiveness and good practice. It is culturally responsive and supports Aboriginal social and emotional wellbeing and self-determination. It is also an example of an Aboriginal initiative aiming to equip participants with the skills to reassert their Aboriginal identity, responsibilities and roles within in a post-colonial society6.

In summary, the evaluators described Red Dust Healing as a program which can provide people with a means of dealing with severe trauma and in so doing, make transformations to their own lives to the benefit of themselves and the people in their lives5.

Red Dust Healing is rated very highly as strong evidence of effectiveness, commitment and alignment with CBPATSISP best practice principles. Importantly, the program is only delivered to communities where members have invited their assistance which respects the community’s rights of self-determination. Red Dust Healing builds strength and capacity in Aboriginal and Torres Strait Islander communities, especially through providing materials and resources that are appropriate for the needs of Aboriginal peoples in diverse community settings.

  1. Red Dust Healing. The Red Dust Story 2019 [Available from: https://www.caritas.org.au/learn/programs/australia—red-dust-healing-program.
  2. Working Together Second Edition-Aboriginal and Torres Strait Islander Social and Emotional Wellbeing: https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/working-together-aboriginal-and-wellbeing-2014.pdf
  3. Red Dust Healing. Red Dust: about the program 2019 [Available from: https://www.caritas.org.au/learn/programs/australia—red-dust-healing-program.
  4. Caritas Australia. Red Dust Healing Program Evaluation: Final Report 2018. 2018
  5. Caritas Australia. Red Dust Healing Program Evaluation: Final Report 2018. https://www.caritas.org.au/learn/programs/australia—red-dust-healing-program (accessed 2019 May 30).
  6. School of Indigenous Studies UWA. Suicide Prevention in Aboriginal and Torres Strait Islander Communities: Learnings from a meta-evaluation of community-led Aboriginal and Torres Strait Islander suicide prevention programs. 2016. https://www.atsispep.sis.uwa.edu.au/resources.

Strong Foundations (NSW)

The Strong Foundations program provides for early intervention that includes culturally appropriate support to Aboriginal children and their families about mental health and wellbeing. The aim of the program is to raise awareness of mental health wellbeing, increase resilience, encourage help seeking behaviours, develop coping strategies, build positive self-esteem and increase cultural pride and connection.

Contact: Nathan Deaves, Executive Manager, Health and Wellbeing
South Coast Medical Service Aboriginal Corporation
T: 02 4448 0200
E: nathan@southcoastams.org.au

This program is delivered through the South Coast Medical Service Aboriginal Corporation (SCMSAC) which is situated in the Shoalhaven region of New South Wales. The program uses Aboriginal cultural activities, practices and influences, group sessions, capacity building workshops and individual counselling to promote help seeking behaviours, encourage resilience, and improve social and emotional wellbeing to minimise risk of suicide within primary school students and their families. The program is delivered to seven primary schools and has connections with appropriate governments and non-government agencies throughout the Shoalhaven region.

Strong Foundations has been built upon the success of the Koori Kids Wellbeing Program which was funded from 2007 to 2013 under the Commonwealths National Suicide Prevention Strategy1, the current form and delivery is funded by COORDINARE – South Eastern NSW Primary Health Network, until June 2022.

There are five components to the program, these include:

  1. the delivery of wellbeing education through group sessions in targeted primary schools.
  2. the inclusion of psychological or counselling sessions for children and parents
  3. community capacity building programs that are targeted towards suicide prevention awareness and mental health literacy.
  4. school holiday activities for children, their families and community, and
  5. data gathering and analysis to inform evidence-based program evaluations.

The program specifically targets Aboriginal and Torres Strait Islander pre-primary and primary school students aged between 8-13 years, including follow-up to children transitioning to high school, their parents, family members and caregivers within the catchment area of the Shoalhaven.

Participants attending the group sessions are required to complete participation consent, signed by the parent or carer prior to attending weekly one-hour sessions which are delivered during school hours. Group sessions focus on specific topics, including:

  • Understanding Self Others and Culture
  • Communicating With Others
  • Positive Thinking
  • Help Seeking
  • Building Support Pathways

The groups sessions use a variety of interactive activities to help students understand and grasp concepts of each topic, ensuring participants are actively involved and increasing outcomes. Some of these activities include:

  • yarning circle
  • art and craft
  • Aboriginal cultural activities and practices
  • outdoor group activities
  • health and wellbeing educational games
  • mindfulness techniques
  • education of significant days, and
  • story telling with community Elders.

The program uses “year, term and session plans” in delivering these activities, while the cultural content of these sessions is guided by the “SCMSAC Cultural Pack”, which has been developed by local Aboriginal people. The facilitators, who must be Aboriginal or Torres Strait Islander, are able to discuss with the parents or carers in a culturally safe manner that the child or themselves be referred to the SCMSAC’s primary health services, the family support section and psychological services. The facilitators liaise with the school principal and other staff to ensure that there is cooperation at all levels. If there is an Aboriginal educational assistant at the school, this person may co-facilitate where appropriate. Activities may also include the involvement of local elders, key community leaders and role models to provide support and encouragement to participants.

To access individual psychological and counselling activities, participants must be referred and undertake SCMSAC screening and intake processes to ensure needs are identified and the most appropriate service is provided. The counsellor and psychologist uses a variety of age-specific traditional and innovative techniques to support the needs of children and their families ensuring that the session is tailored to the specific needs of the participants. These include, but are not limited to, play and art therapy, narrative therapy, mindfulness, emotion-focused therapy and behavioural therapy.

There is an equal focus on recording data, analysing this data and reporting within the program and to the NSW Health Department through the Primary Mental Health Care Minimum Data Set. Independent evaluations are undertaken at appropriate intervals.

Strong Foundations has as its main objectives to:

  • provide culturally inclusive and school based peer support and mental health literacy with Aboriginal and Torres Strait Islander children/young people and their families, to build resilience and support early help seeking behaviours and overall social emotional wellbeing
  • identify children and young people and families who require more intensive support and delivery of psychological therapies and techniques to those children and families, and
  • deliver evidence based culturally appropriate mental health and suicide prevention education and training programs throughout selected school in the Shoalhaven region.

Through the SCMSAC, Strong Foundations employs professional psychological and counselling sessions that are evidence-based as well as being culturally safe to those who have been identified as being in need. Additionally, the program provides education and awareness to the community regarding mental health and factors leading to suicide risks in Aboriginal and Torres Strait Islander children. Capacity building within families (such as gatekeeper training) is developed along with the community’s ability to recognise and attend to those who display poor mental health issues and behaviours that may lead to suicide.

Mental health literacy is presented using evidenced-based syllabi, Be You2. Be You builds on the success and learnings from five existing programs aimed at promoting social and emotional health and wellbeing for children and young people in the education space: KidsMatter Early Childhood, KidsMatter Primary, MindMatters, Response Ability and headspace School Support. Be You is building on the evidence base and ten years of experience of these programs. These programs are now integrated into Be You – one single, national initiative delivered through early learning services, primary and secondary schools.

Another syllabus used is Aussie Optimism.3 This is an evidence-based mental health promotion program for children in primary and lower secondary schools. Aussie Optimism is based on Martin Seligman’s theories that focus on strengths-based problem solving to deal with personal issues. This program was developed in 1997 and extensively evaluated. It intends to:

  • reduce mental health difficulties
  • increase recovery from depressive disorders
  • reduce the incidence of suicidal ideation and behaviour
  • increase the recovery from suicidal ideation and behaviour
  • increase pro-social behaviour, and
  • reduce the likelihood of drinking and smoking at later stages.3

Strong Foundations has established itself over a number of years as a reliable program in providing resilience skills development in primary school children. It is delivered in a culturally safe manner and provides for transition of these students into high school.

The program has provided skills and knowledge to families and the community. For example, during the six-month evaluation period, 47 adults attended Aboriginal Mental Health First Aid which was delivered by qualified SCMSAC staff.

The program, through the SCMSAC has provided physical and mental health services to children and adults in a seamless referral process. This includes case management for risks such as family relationship breakdowns and parenting programs as well as for substance abuse.

Strong Foundations liaises with government and non-government community organisations is the delivery and evaluation of the program.

Strong Foundations has had an independent evaluation undertaken on its activities during the first half of 2018.4 This evaluation included qualitative and quantitative analyses. Qualitative data included meeting minutes, session plans, teaching and learning materials, and informal interviews. Qualitative data was based upon two measures administered post-session. One was titled My Feelings which was developed for Koori Kids and uses a five-point Likert scale. The other is a dichotomous measure titled Understanding Culture. Seventy-one sessions were run during the six-month review period with a total number of responses of 231 for the first measure. The data was collected from six schools in two cohorts – one being Years 3 and 4 and the other Years 5 and 6.

The data collected is descriptive and does not allow for a statistical analysis of the efficacy of the program as a pre- and post-program administration of the measures could indicate. The program and the evaluation did not seek ethics approval which might limit on-going evaluations on the effectiveness of the program. The ability to track a child’s progress over time is not practical for the project as the data would need to be de-identified which is not something seems to be part of the program. Health data as it applies to the NSW Health Department is entered through the SCMSAC which might be able to be accessed at a later date. Additionally funding remains a difficult resourcing issue both for data collection and for resourcing operational staff.

In the My Feelings measure, the children were asked how they responded to their feelings. That is, did they have strategies for dealing with negative feelings and what self-regulation they employed. The evaluation suggests that as a result of the program, there may be some positive impact on the children’s ability to self-regulate and develop strategies to cope.

The evaluation suggests six recommendations:

  1. Ensure the evaluation and research proposal is assessed by a Human Research Ethics Committee, as great care and consideration is required particularly if considering the inclusion of capturing the children’s experiences.
  2. Adopt a study design that utilises a pre and post data collection method over a longer period of time (12 months) to assess impact of the program at the individual level.
  3. Collect qualitative data such as feedback from school staff, parents of the children and possibly the children.
  4. Evaluate the counselling and therapeutic support provided within the program, including the appropriate referral pathways.
  5. Include an evaluation of the impact and use of the Understanding Culture and My Feelings component of the program, exploring the validation of these tools.
  6. Assess the need for program scale up to further expand the program to other parts of the region, including the key partnerships that are required in order for scale up to occur.

The lack of recurrent funding for the program is noted as a barrier to the effective management and resourcing of the program. This funding model presents the operational staff with a lack of certainty for their continued employment. Additionally if Recommendation 6 were to be considered, then a significant increase in funding would be required which, as noted, would need to include other parties to become involved.

The evaluation’s literature review draws heavily on the work of the current literature regarding suicide prevention for Aboriginal and Torres Strait Islander people which is consistent with ATSISPEP guidelines. However the evaluation suggests that more needs to be known about how to deliver suicide prevention programs to primary school children. The evaluation also suggests that Strong Foundations meets many of the requirements of the current understanding regarding suicide prevention programs.

Strong Foundations demonstrates many of the principles that makes for a successful suicide prevention program. There is a strong community and cultural focus, it adheres to the priniciples of Indigenous governance and is culturally respectful. Local Aboriginal and Torres Strait Islander people were involved in the development and are continuing to deliver the program through Aboriginal and Torres Strait Islander facilitators and supporting staff. There are strong links to the South Coast Medical Service Aboriginal Corporation as well as to other local services which are culturally safe.

The program seeks to gather information about the efficacy of the program and the benefits that come to the children, their parents, families and the community. While this information could be improved through pre- and post-testing, the program shows that it strengthens with children’s sense of cultural identity and self-regulation which in turn enhances their resilience. The program also builds family and community capacity through the gatekeeper program. The CBPATSISP rates this as an evidenced-informed promising program.

  1. Department of Health. Evaluation of Suicide Prevention Activities – Koori Kids Wellbeing Program.
  2. Be You. https://beyou.edu.au/
  3. Aussie Optimism. Curtin University Health Sciences.
  4. Strong Foundations Report, December 2018. Longbottom, M.; Clapham, K.; Kelly, P. Australian Health Services Research Institute (Centre for Health Service Development).

Telling Story (WA/NT)

Telling Story are collaborative, place based mental health projects based on Narrative Therapy principles delivered in Western Australia and the Northern Territory. Telling Story commenced in 2015 in Kalumburu, following a request from community Elders for community members to meet, talk, heal and share hopeful stories.

Contact Details

Sudha Coutinho                sudhacoutinho@gmail.com         0403840293

Clare Wood                        clare.wood10@gmail.com            0438859727

Telling Story supports people and communities to uncover and celebrate stories of strength, hope and resilience. The sharing of these stories supports people to stay strong in the face of community problems such as suicide and alcohol and drug misuse 1. 2. Telling Story facilitates intensive week-long projects in communities and provides a series of workshops to reach different groups in the community depending on community context. Telling Story and the narrative ideas used in these projects can be utilized across age groups and genders.

The methodology uses the principles of Narrative Practice and centers on people as the experts in their own lives viewing problems as separate from people. Narrative Therapy assumes that people have many skills, competencies, beliefs, values, commitments, and abilities that will assist them to navigate the problems in their lives 3. Telling Story is a strengths-based practice that honours the individual’s and community’s agency, focusing on the development and enhancement of people’s social and emotional competencies.

Telling Story collaborates with local clinical and community workers to help shape the project workshops to the local context and, where possible, co-facilitates with local health and community workers providing capacity building in narrative methodology. The workshops are held at a variety of community venues as well as ‘on country’ depending on community needs and wishes. Activity based workshops which use collective Narrative Therapy methodologies such as the ‘Tree of Life’ or the ‘Team of Life’ are facilitated at times within the project 3. These methodologies use the richness of meaning which can be found in ‘tree’ and ‘sport’ metaphors fostering connection to cultural practices and identity.3, 4. Stories arising out of conversations during the workshop are documented and returned to participants in variety of ways including the writing of therapeutic letters, audio and video recordings, as well as creation of posters.

Telling Story facilitators seek permission from storytellers to invite community members and people outside the community to listen and witness the audio and video stories as an ‘Outsider Witness Process’ 5, 6.

The sharing of the stories via online video platforms enables a broader audience to view and witness the stories and responses to be collected to return to the storytellers. 7.

Program objectives are determined in collaboration with local community navigators, who consult with Elders and the local context.  Telling Story aims to:

  • build capacity within individuals and the community by exploring their responses to loss, grief and trauma and the impact these experiences have had on their lives
  • uncover stories of hope, strength and resilience to better equip individuals and communities to navigate the issues they are facing in their lives such as mental health concerns and suicide.
  • Participants at the end of the workshop are able to identify the skills, knowledge and wisdom they possess to navigate and respond to problems in their own lives as well as issues impacting their families and communities.
  • Participating communities create an archive of stories which lay testimony to their skills, knowledge and wisdom.
  • Community members have the opportunity to learn from each other, provide peer support both within communities as well as between communities.
  • Participants identified at the workshops as requiring additional support are linked to local networks of support. This includes physical health, mental health and community services providers.

Not yet evaluated

Telling Story aligns with the principles outlined in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP)1. Specifically, the program establishes a cultural and community focus by involving Elders and senior community members where possible and tailoring of the content to local customs and languages. The program strengthens Indigenous governance and capacity by using, where possible, local community members to co-facilitate the workshops. The program builds resilience and promotes social and emotional wellbeing within individuals and the community.

Telling Story is only delivered to communities where members have invited the facilitators’ assistance which respects the community’s rights of self-determination, governance and promotes a continued connection to culture and land. The program is inclusive of gender and LBGTI community members.

Telling Story uses primary healthcare organisations and considers the individuals’ health holistically by including community engagement and cultural awareness in wellbeing and early intervention services. The program has at its core the ability to refer those at risk to these services.

In summary, Telling Story is promising evidence of effectiveness and practice. It is a program designed to respond to local needs and the interests of community members. Ideally a formal and independent evaluation should be undertaken to better advise the program managers of the effectiveness and long-term benefits to the community and social and emotional wellbeing.

1. Wingard, B. (2001). Introduction. In B. Wingard & J. Lester (Eds.), Telling our stories in ways that make us stronger (pp. v–vii). Adelaide, Australia: Dulwich Centre Publications

2.Wood, C. (2014). The stories we need to tell. ABC Open: Real stories made by real people from all around Australia. Retrieved from open.abc.net.au/explore/80848

3. Denborough, D. (2008). Collective narrative practice: Responding to individuals, groups, and communities who have experienced trauma. Adelaide, Australia: Dulwich Centre Publications.

4. Chandler, M. J., & Lalonde, C. E. (2008). Cultural continuity as a protective factor against suicide in First Nations youth. Horizons – A Special Issue on Aboriginal Youth, Hope or Heartbreak: Aboriginal Youth and Canada’s Future. 10(1), 68–72. Retrieved from www2.psych.ubc.ca/~chandlerlab/Chandler%20&%20 Lalonde%20(2008).pdf

5. Hernandez, R. (2008). Reflections across time and space: Using voice recording to facilitate ‘long-distance’ definitional ceremonies. The International Journal of Narrative Therapy and Community Work, (3), 35–40

6. Denborough, D. (2014). Narrative therapy charter of story-telling rights. Retrieved from dulwichcentre.com.au/narrative-justice-and-human-rights/

7. Adelson, N., & Olding, M. (2013). Narrating Aboriginality on-line: Digital storytelling, identity and healing. The Journal of Community Informatics, 9(2). Retrieved from ci-journal.net/index.php/ciej/ article/view/740/1004

8. ATSISPEP Website

The Healing Foundation (NSW)

The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by colonisation and to support the healing and reconnection to culture.

Contact:
Phone:
(02) 6272 7500/Email: info@healingfoundation.org.au

The Healing Foundation provides a critical role in supporting the healing and reconnection to culture for Indigenous individuals, families and communities – which is arguably a national priority to reducing the high rates of suicide in Australia. By funding locally driven, culturally strong healing initiatives across the country, The Healing Foundation is enabling Indigenous peoples to more effectively participate in employment, education, parenting, cultural and community life and self-determining health and wellbeing outcomes. As part of its overall evaluation and performance reporting process, The Healing Foundation requires all funded projects provide to data on agreed national outcomes and associated indicators. It also collects in-depth information through case studies. This data and the case studies provide a picture of the healing work and its effectiveness. A number of projects also undertake more in-depth evaluations with external organisations.
The Healing Foundation funds a large number of projects across Australia that aim to address the impacts of social determinants on social and emotional wellbeing of individuals, families and communities at key points across the life course. For example, they support parents and carers to create healthy, positive environments for children and young people to reconnect with schooling or prepare them for entering the workforce. Several projects work in partnership with government and community organisations to ensure communities are safe, by supporting families to address the role violence, gambling or substance misuse plays in their lives. All projects contribute to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples by creating healing from pain, suffering and trauma.

A core aspect underpinning best practice in programs funded through The Healing Foundation (HF) is the notion of cultural continuity and identity in Aboriginal communities. Cultural continuity is enabled where communities have an understanding and access to their past and share and have ownership of a common future. The Healing Foundation supports the delivery of services that are:
• Founded on strong culture and traditional ways of healing from trauma and loss
• Enabling self-determination
• Building stronger health, education and social services
• Working with women to participate in leadership and governance roles
• Supporting language

The HF draws heavily on international suicide prevention research which has compelling evidence to show that culture, cultural continuity and self-determination act as protection against youth suicide (Chandler & Lalonde 2008).

• Increased the number of people who have understanding and access to a wide range of healing services
• 137 Aboriginal and Torres Strait Islander people employed in 17 projects
• 100 per cent of projects designed, developed and delivered by Aboriginal and Torres Strait Islander people ensuring contextually appropriate healing services for participants
• 2465 children, young people, families, men, women and Elders participated in healing activities, demonstrating the need for and importance of healing work
• Almost 650 cultural activities provided, helping people reconnect with culture and support, strengthening cultural identity and pride
• 99 per cent of participants reported improved physical, emotional, social, spiritual and cultural wellbeing as a result of participation in the healing projects
• Development of strong organisational partnerships and linked-up service delivery allowing for holistic services and interventions
• Positive publicity that has celebrated Aboriginal and Torres Strait Islander culture and educates the wider community about healing
• Significant contributions to the Closing the Gap agenda in the areas of health, economic participation, safe communities and governance and leadership. (Healing Foundation 2013).

Evaluation pending

The Healing Foundation was rated very highly as strong evidence of effectiveness and best practice. It provides high quality integrated services, culturally appropriate community activities, engages youth, builds cultural strengths, supports leadership, life skills and social competencies, meets many objectives with regard to Life promotion and resilience-building strategies and emotional wellbeing, addressing racism, partnerships with community organisations and increased support for Indigenous.
The Healing Foundation is committed to developing an evidence base and disseminating information on best practice is described in a number of healing programs and initiatives available on their website.

The Marumali Program (QLD)

The Marumali Program® promotes social and emotional wellbeing, training for Aboriginal and Torres Strait Islander service providers to provide culturally appropriate support to Aboriginal Stolen Generations survivors who are healing from the trauma they have suffered as a result of removal. While the Marumali Program® is based in Brisbane, it is delivered throughout Australia.

Contact: Shaan Peeters

Mobile: 0481 340 258

Email: shaan@marumaliprogram.com.au

Established in 2000, the Marumali Program® is based upon the lived experience of Lorraine Peeters, who was forcibly removed from her family at the age of four years. Aunty Lorraine’s reaction to this trauma was delayed until she was in her fifties. Marumali is a Gamilaroi word meaning ‘put back toghether’.2 She has used her experiences to develop the Marumali Journey of Healing Model. This journey develops the skills, knowledge and abilities of Aboriginal and Torres Strait Islander people to help others to overcome intergenerational trauma through a series of workshops.

Several studies confirm that removal from natural family has been associated with higher rates of emotional distress, depression, poorer physical health and higher rates of smoking and use of illicit substances. It has also been associated with lower educational and employment outcomes. These consequences of separation not only affect those who personally experience removal, but can be trans-generational, impacting on children, families and communities.

The Marumali Journey of Healing Model was developed by an Aboriginal survivor for Aboriginal survivors; and is:

  • culturally appropriate for those who were removed
  • culturally appropriate for the families and communities they were removed from
  • respectful of the autonomy and strength of survivors
  • a clear path forward for survivors, regardless of how they were removed or what has happened since
  • promoting community and cultural governance as it allows survivors to set the pace, rate and direction of their healing journey
  • holistic and includes the spiritual dimensions of healing
  • able to address the core issues which undermine survivors, and allows for personal growth, and
  • able to address the trans-generational effects of removal.

The Marumali Program is delivered through a range of three workshops to service providers who are working with survivors and also directly to the survivors themselves including those within correctional facilities. One youth workshop is also available.

The Journey of Healing recognises that social and emotional wellbeing is based upon the recovery of Aboriginal identity and culture and not based on a Western biomedical or consumerist model of recovering from a mental illness. Additionally, the program recognises that healing occurs over differing periods for different survivors.

Workshop outlines

Aboriginal & Torres Strait Islander Service Providers (4 day)

Provides counselors/ support workers with the knowledge and skills to provide culturally appropriate and culturally safe support to survivors. This includes strategies through which the complex issues of trauma can be dealt with at the pace, preferred setting and goals of the survivors.

Risk Management Workshop for Workers (2 day)

  • Using the 4 day workshop as a prerequisite, this workshop assists counsellors to identify risk factors and the use of strength-based concepts to help survivors continue their healing.
  • These two workshops (6 days) form the basis for recognition for one unit of competency in the Nationally Accredited Health training package.

Trauma-Informed Care For Stolen Generations Workshop For Non-Aboriginal Service Providers (2 days)

A workshop for non-Aboriginal counselors/support workers who wish to understand in greater detail how to ensure that trauma in survivors is not reactivated.

Marumali Journey of Healing Workshop (2 or 3 day)

This workshop is for survivors of removal and aims to effectively support healing through understanding that healing is holistic and that survivors may progress at differing speeds through the healing journey.

Aboriginal & Torres Strait Islanders Within Correctional Facilities (4 day)

This workshop is for those survivors who are incarcerated and provides for a culturally safe approach towards dealing with trauma associated with removal, grief, loss and the dimensions of healing.

Youth Program

Using the basis of the Journey of Healing, this program is contextualised for young people’s social and emotional wellbeing using art and other activities in a culturally safe and age appropriate environment. Discussions involve identity issues, grief and transgenerational trauma as well as promoting cultural connection to community and country.

The Marumali program aims to:

  • increase the quality of support available for Aboriginal survivors of removal policies;
  • enable all Aboriginal people affected by past removal policies to identify and understand their trauma, the stages of healing from trauma;
  • provide ways to respond to the trauma and support they may need on their ‘healing journey’; and
  • improve service delivery by providing advice to service providers on how to work effectively with Aboriginal people affected by intergenerational trauma.

Key elements of the program are to:

  • improve service delivery by providing advice and supporting participants and organisations to realize the widespread impact of removal and understand the potential paths for recovery
  • recognize the signs and symptoms of trauma associated with removal in clients, families and communities and
  • to avoid retraumatising survivors and their families; and respond by integrating knowledge into their policies, procedures and practices.

Between 2000-2019, more than 350 workshops had been delivered to more than 3400 participants, across all of Australia. Anecdotal evidence suggests that the majority were Aboriginal and most had a family member who had been affected by past removal policies.

Results from the workshop evaluations, a survey of past participants and two case studies confirmed the program had several strengths including:

  • participants were satisfied with the program’s content
  • increased awareness of the past removal practices
  • it had increased participant’s understanding of their client’s needs
  • it increased awareness of intergenerational trauma
  • the knowledge participants had learned had been used in their workplaces
  • promoted participants’ own personal development and self-awareness, and
  • increased sense of cultural identity.

An independent evaluation of the Marumali Program was completed in 2014. The evaluation was funded by the Healing Foundation. The evaluation is not publicly available, though was analysed as part of preparing the practice profile for the Australian Institute of Family Studies3 website. The evaluation was developed and planned through a collaboration between Shaan Peeters, the Healing Foundation and the external evaluation team. It aimed to:

  • assess the quality of three of the programs (these were: the five day Aboriginal service provider program, the two day non-Indigenous service provider program and the inmate program)
  • describe the impact of the program on its target audience
  • describe the strengths of the program, and
  • describe its limitations and areas for improvement.

The evaluation drew on a mix of existing organisational data and new research, including the following data collections methods:

  • organisational documents review
  • analysis of previously completed workshop evaluation forms from between 2002-12
  • online survey completed by 59 previous workshop participants
  • two case studies of previous participants, and
  • interview with the program’s key staff (Lorraine and Shaan).

The evaluation findings and the program staff highlight that the most effective aspect of the program in achieving success is that participants can relate to the experience of Lorraine Peeters and how her story can be used as a model to dealing with the trauma caused by the past removal from family. The evaluation found that the program builds individual, family and community capacity; was developed to address issues in the local community and that the workshops were based on culturally safe, trauma informed practice.

However, the evaluation did recommend actions to:

  • improve community awareness of the program through a review of current marketing practices
  • improve access through establishing partnerships with other organisations to deliver it in a variety of settings, and
  • strengthen the ongoing monitoring and evaluation practices of the organisation.

These suggestions have since been considered and some have been integrated into the program.

Marumali meets many of the ATSISPEP and CBPATSISP principles and guidelines for best practice in Aboriginal contexts. The program has been written and developed by Aboriginal and Torres Strait Islander people, social and historical context has been taken into account and there is ongoing activity in place to ensure a continuous quality improvement process.

An external evaluator, Professor Gail Garvey, was contracted by the Department of Health in 2000 to evaluate the pilot workshop. The evaluation was very positive and the Department funded the delivery of the Marumali Journey of Healing workshops to train Aboriginal and Torres Strait Islander counsellors and case workers employed in Link-Up services and ACCHOs from 2000 – 2006.

The Marumali Journey of Healing model and workshop was endorsed by co-author of the Ways Forward report, Professor Beverly Raphael (Letter of Support, 2000) and Aboriginal organisations Link-Up NSW (2001) and the National Aboriginal Community Controlled Health Organisation (NACCHO) (2002) as being a safe, effective and culturally appropriate model to use with survivors who had been forcibly removed from their families, communities and country.

The Marumali Journey of Healing has been variously identified as a ‘good practice,’ ‘promising practice’ and ‘best practice’ Aboriginal model of healing for those who have been forcibly removed by the Moving Forward Conference (2002), the evaluation of the Bringing Them Home and Indigenous Mental Health Programs.4 5 The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2004–2009 identified the Marumali Journey of Healing as an initiative that achieved the key result area of ‘recognising and promoting Aboriginal and Torres Strait Islander philosophies on holistic health and healing’.5

  1. Peeters, L. The Marumali Program: An Aboriginal Model of Healing. In Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (First Edition) (2010) eds. Purdie, Nola; Dudgeon, Pat; and Walker, Roz, pp 285 – 292.
  2. Peeters, L., Harmann, S & Kelly K. The Marumali Program: Healing for Stolen Generations. In Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (Second Edition) (2014) eds. Dudgeon, Pat; Milroy, Helen and Walker, Roz, pp 493 – 507. [Available: https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/working-together-aboriginal-and-wellbeing-2014.pdf Accessed 2019 December 9
  3. Marumali Healing Program Knowledge Circle Practice Profiles. Australian Institute of Family Studies. [Available: https://apps.aifs.gov.au/ipppregister/projects/marumali-healing-program Accessed 2019 December 10
  4. Wilczynski A, Reed-Gilbert K, Milward K, Tayler B, Fear J, Schwartzkoof, J. Evaluation of Bringing Them Home and Indigenous mental health programs. Report prepared by Urbis Key Young for the Office for Aboriginal and Torres Strait Islander Health. Canberra; 2007.
  5. Social Health Reference Group (SHRG). In: National Strategic Framework for Aboriginal and Torres Straits Islander People’s Mental Health and Social and Emotional Well Being 2004–09. National Aboriginal and Torres Straits Islander Health Council and National Mental Health Working Group. 2004. Canberra: Department of Health and Ageing.

Additional reading:

Human Rights and Equal Opportunity Commission (HREOC). Submission to the Senate Legal and Constitutional Affairs Committee on the Inquiry into The Stolen Generations Compensation Bill. 2008. [Available: https://www.humanrights.gov.au/our-work/legal/inquiry-stolen-generation-compensation-bill-2008  Accessed 2019 December 9

Uti Kulintjaku Project (NT)

The Uti Kulintjaku Project is under the direction of Ngaanyatjarra Pitjantjatjara Yankunytjatjara  (NPY) Women’s Council. Now in its sixth year, it is an innovative mental health literacy, capacity, and resilience-building initiative led by respected Anangu (Aboriginal) cultural and community leaders who are working at the interface of two knowledge systems, Anangu and Western.

Contact:
Liza Balmer (CEO)
Phone: (08) 8958 2345/Email: Liza.Balmer@npywc.org.au

Organisation Email: enquiries@npywc.org.au

Postal address: PO Box 8921, Alice Springs, NT 0871

Uti Kulintjaku is an innovative mental health literacy, capacity and resilience-building initiative led by respected Anangu (Aboriginal) cultural and community leaders who work collaboratively with mental health professionals. The program operates at the interface of two knowledge systems which operate in three languages (Pitjantjatjara, Ngaanyatjarra and English) and draws on the best of both knowledge systems to find new ways to address the challenging issues related to improving Anangu social and emotional wellbeing (SEWB).

The Uti Kulintjaku Project is grounded in cultural knowledge and focuses on healing, the strengthening of SEWB, community capacity and resilience, whilst also encouraging help-seeking behaviour. Its reach and sphere of influence extends beyond the Anangu domain to the local non-Aboriginal domain to support both universal and selective improvement of SEWB. Anangu team members share stories of supporting young people in their communities experiencing distress which are likely to be preventing suicide and encouraging help seeking behaviour.

A key aim of the Project is to develop mental health literacy and promote the discussion of mental health issues using animated drawings with English sub-titles. Each animation has two versions, one in Pitjantjatjara and another in Ngaanyatjarra. Young people from the Anangu community are the key audience for these animations which are shown on ICTV, the program website or by video recordings. Within program workshops, participants are provided with nurturing therapies and art to support healing.

Identifying the protective factors that enhance the SEWB of Aboriginal communities, as well as those factors that contribute to community distress and suicide, is paramount. It requires an in-depth knowledge of the historic, social, cultural and economic risk factors at play in each community, which are best known and understood by community residents themselves The Uti Kulintjaku Project takes a long-term view on achieving change to improve Anangu mental health and wellbeing.  It recognizes that while external change agents can help to catalyse action or create spaces for people to undertake a change process, healing and empowerment can occur only by communities creating their own momentum.

The overarching objectives are to:

  • Develop a team of Anangu experts in mental health and wellbeing who will take their knowledge into their leadership roles in other organisations and communities, to their families and workplaces and to young people on bush camps.
  • Encourage and enable Anangu team members to share their understanding or experience in mental health and wellbeing, including traditional and cultural knowledge as well as contemporary and lived experience.
  • Encourage and enable Anangu team members to deconstruct and combine western mental health knowledge with Anangu knowledge.

Essentially, the Anangu team deconstructs western mental health knowledge, compares and combines it with Anangu cultural and traditional knowledge, and reconstructs it into meaningful information in their own languages that also draw on Anangu knowledge. The team encourage Anangu to use this information to make informed decisions in their various roles and workplaces. They also offer a two-way knowledge exchange with western mental health services in the area so that they may better understand and respond to the Anangu experience.

The Uti Kulintjaku Project has created a unique space for Anangu and non-Aboriginal people, who share a commitment to make a difference, come together and discuss issues, share knowledge and learn how to unite and better respond to improve Anangu wellbeing.

In addition, the team has responded to a need for Anangu leaders to be engaged in considering and addressing the complex and concerning issues in their communities. A model, Uti Kulintjaku Iwara which translates as the path to clear thinking, has been developed which facilitates safe ways to talk about difficult issues, nurtures healing and empowerment, and finds new ways of enhancing mental health and wellbeing. A multi‐lingual dictionary of words and phrases has been created and other novel resources have been produced. Very importantly, partnerships with mental health services have been strengthened1.

A developmental evaluation conducted by Togni1 utilised data collected through ten three‐ to four‐day workshops over three years, reflective practice, participant observation, focussed discussion groups with Aboriginal participants, and 21 semi‐structured, in‐depth key stakeholder interviews. The evaluator concluded that the healing, empowerment and leadership outcomes for the Aboriginal participants were consistent with programs identified as most effective in enhancing the social and emotional wellbeing and suicide reduction in Aboriginal communities. Further, it was confirmed that the program had resulted in a range of outcomes at personal, group and project levels including the capacity development of a team of senior Aboriginal women, and the achievement of bi‐cultural understanding of mental health and an acknowledgement of culture as enhancing Aboriginal mental health and wellbeing.

A follow-up evaluation was completed in late 20182. This report described the way of working developed through the Uti Kulintjaku Project as effective in supporting Anangu and non-Aboriginal people to learn from each other and work together to identify ways to respond to challenging issues related to mental health and wellbeing in communities. The essence of this way of working comes from the Pitjantjatjara and Ngaanyatjarra phrase ngapartji ngapartji meaning reciprocity in relationships.

Importantly, the 2018 evaluation indicated that the risks associated with suicide had been reduced by the sharing of bi-cultural learning with Anangu families and mainstream mental health and social service providers.

Conclusions

The Project’s model and the healing, empowerment and leadership outcomes for the Aboriginal participants are consistent with programs identified as most effective in enhancing the social and emotional wellbeing and ‘suicide proofing’ of Aboriginal communities. The Uti Kulintjaku Project has secured six years of funding for suicide prevention. The model developed has potential application to address other complex social and health issues in various contexts1.

Promising program, assessment pending

  1. Togni SJ. The Uti Kulintjaku Project: The Path to Clear Thinking. An Evaluation of an Innovative, Aboriginal‐Led Approach to Developing Bi‐Cultural Understanding of Mental Health and Wellbeing. Australian Psychologist 2017;52(4):268-79.
  2. Togni SJ. Uti Kulintjaku Project | Summary Report. Available upon request from Angela Lynch, Manager Ngangkari Program, NPYWC via Angela.Lynch@npywc.org.au.

Youth Empowerment and Healing Cultural Camp (YEaHCC)

The one-week camps led by the Burrongglo Aboriginal Corporation provides the opportunity to focus on the protective, cultural factors young people who are considered at risk by  learning about sharing, caring and community values through greater connection to culture and country.

Contact Number: 0487 249 145

Email: burrongglo290@gmail.com

Contact: Geraldine Shadforth

The Burrongglo Aboriginal Corporation (BAC) hosts the Youth Empowerment and Healing Cultural Camp (YEaHCC)1 which is run as six independent one-week camps during school holidays. The camp is located on the Dampier Peninsula approximately 190kms north of Broome, Western Australia. In response to having experienced the trauma of suicide in the communities in the Kimberley, the BAC recognised the need to offer assistance to those children and youth who were at-risk throughout the Kimberly region of Western Australia.

The content of the camp emphasises importance of strengthening wellbeing and resilience through social empowerment and healing which centres on re-establishing young people’s sense of identity and spiritual and cultural connection with self, family, community, country and sea. Additionally, the camp offers training and guidance with the development of leadership skills, learning about bush medicine, bush food and hunting.

Potential participants are referred through a form which includes descriptions of the:

  • risk factors for client / family
  • services provided by referral Agency to date
  • services provided by other known Agencies / Organisations to date
  • behavioural issues for staff OH&S (if applicable)
  • special requirements (medical, dietary, cultural)

Between seven and ten youth attend each camp at a cost of approximately $1,500 per participant which includes food, transport, supervision and activities. Two community-nominated participants may attend without charge.

The YEaHCC camps for young people considered at risk aim to:

  • increase engagement by providing a culturally safe and inclusive space that fosters support and imparts life skills
  • promote and strengthen cultural, social, emotional, health and wellbeing by engaging young people in cultural and social activities and outings on country
  • enhance and promote cultural identity, belonging and knowledge
  • encourage and strengthen peer support amongst young people
  • develop, empower and nurture leadership, resilience, confidence and healing,
  • increase awareness of local youth support services and programs available; and strengthen young people’s natural support networks, and
  • promote the process of recovery, empowerment and healing from the trauma, grief and loss associated with suicide.2

The camps provide the chance to increase the understanding of the harmful impacts of suicide as well as the importance of life preservation. The camps build an understanding of the importance of:

  • identity
  • belonging and culture
  • acknowledgement and worth of self
  • respecting others and Elders and,
  • capacity building of resilience and self-leadership

Additionally, the camps:

  • strengthen traditional and contemporary Aboriginal culture and
  • ensure that the participants have the skills and ability to successfully coexist as a young Indigenous person living in modern and traditional societies.

An internal evaluation of the two years that the program had run was undertaken towards the end of 20183. The ages of participants were between 8 and 18 years, comprising both male and female participants. Self-report measures showed that 70% of the participants perceived that the causes of suicide were due to bullying, family issues and loneliness with the other factors of academic pressure and stress comprising the remaining 30%.

Feelings of the participants were measured with eight categories being mentioned. All participants expressed experiencing feelings of being alone and sad. The more common of these range from damaging property, feelings of uselessness, self-harm, making one’s self ill and causing injury to others. The less common feeling that was mentioned were feelings of anger.

As mentioned above, access to this program is through referral where it is known that the young person is a risk and all participants had had first-hand experiences of suicide. The participants reported that they were better able to deal with these feelings after attending the camp. However the participants also reported that suicide prevention and awareness within their community was lacking as were anti-bullying strategies.

The YEaHCC is rated very highly as strong evidence of effectiveness, commitment and alignment to CBPATSISP best practice principles. The self-sustaining program has been developed and managed by Aboriginal and Torres Strait Islander people for Aboriginal and Torres Strait Islander people.

The program establishes an increased sense of community belonging through providing a greater connection to culture and country to enhance young people’s social and emotional wellbeing. The process is community-led and directed using formal partnerships. The YEaHCC addresses the important, local issues of dealing with the devastating after effects of suicide by promoting healing and hope for the future. All of the participants attending YEaHCC are identified by the communities that it serves.

  1. Youth Empowerment and Healing Cultural Camp (YEaHCC) Newletter Vol 1 Issue 1. 7 November 2017.
  2. Youth Empowerment and Healing Cultural Camp (YEaHCC): A Youth Suicide Prevention initiative at a grassroots level to lead real action and mobilise change. Information brochure 2019.
  3. Youth Empowerment and Healing Cultural Camp (YEaHCC): A Youth Suicide Prevention Initiative at a grassroots level to lead real action and mobilise change. Geraldine and Shonelle Shadforth, Burrongglo Aboriginal Corporation 2018.