PRIMARY HEALTH NETWORKS & FUNDING ORGANISATIONS

At present, most Commonwealth Government funding of suicide prevention programs for Indigenous people and communities is delivered via the Primary Health Networks (PHNs) to Aboriginal Community Controlled Health Organisations (ACCHOs) and mainstream organisations.

The CBPATSISP supports the National Aboriginal Community Controlled Health Organisation (NACCHO) position that ACCHOs should be funded directly as preferred providers of mental health and suicide prevention services for Aboriginal and Torres Strait Islander people, in line with the principle of self-determination.

Until this is achieved, PHNs must take responsibility for commissioning services in ways that empower Indigenous people and organisations, develop their capacity, and support their autonomy.

This section of the Manual contains resources that can help PHNs support the wellbeing of Indigenous people through culturally safe and sustainable commissioning.

RESOURCES TO SUPPORT COMMISSIONING

PHN Guidance Documents

Funding and policy for PHNs

This section of the Manual links to key Department of Health policy documents. It is intended to assist Primary Health Networks (PHNs) in navigating and interpreting the advice provided by the Commonwealth Government in their commissioning of suicide prevention services for Aboriginal and Torres Strait Islander people and communities.

The PHN funding environment for Aboriginal and Torres Strait Islander mental health and suicide prevention

The 31 Primary Health Networks collectively receive about $670 million per year (estimate 2018-19) to deliver regional and local programs in mental health and suicide prevention. This includes around $60 million quarantined for programs for Aboriginal and Torres Strait Islander people. 

Of the remainder, around $400 million is for the PHNs to spend flexibly on programs according to the needs of their regions, while around $200 million is for headspace and youth psychosis services – any of which may be used by Indigenous people.

12 PHNs have also collectively received $48 million over four years to June 2020 to run the National Suicide Prevention Trial, which included two Indigenous trial sites (Darwin and the Kimberley) and another five trials which included Indigenous people among other priority populations. (1)

National and state suicide prevention trials, by PHN and Indigenous focus [link filename: PHN SUICIDE PREVENTION TRIALS]

How PHNs should work with Indigenous Communities 

The Government sets expectations for PHNs in their commissioning of Aboriginal and Torres Strait Islander mental health and suicide prevention services through a collection of guidance documents. Some are Indigenous-specific while most apply to all commissioning, and vary greatly in the level of detail they include about how to apply the guidance in PHNs’ work with Indigenous communities.

Primary Health Networks (PHNs) and Aboriginal Community Controlled Health Organisations (ACCHOs) – Guiding Principles – 2016

Overarching all PHN commissioning for Aboriginal and Torres Strait Islander communities (including physical as well as mental health), this document establishes a template for the relationship between PHNs and ACCHOs, articulating principles of Indigenous health, culture and governance as they are to be applied by the PHNs across all their work:

“The establishment of PHNs provides an opportunity to build connections across the health system to further improve access for Aboriginal and Torres Strait Islander people to appropriately targeted care that is effective and culturally appropriate, and importantly, to ensure that there is full and ongoing participation by Aboriginal and Torres Strait Islander people and organisations in all levels of decision-making affecting their health needs. 

There are four key factors for improving quality of life and achieving health equity across all aspects of the social determinants of health:

  • connection to culture
  • allowing Aboriginal and Torres Strait Islander people to determine and implement the solutions
  • improving cultural awareness and respect across the wider Australian population, and
  • effective partnerships – Aboriginal and Torres Strait Islander health is everybody’s business.”

This guidance also sets out in detail the respective roles of ACCHOs and PHNs working in partnership in domains including:

  • Closing the Gap
  • Cultural competency
  • Commissioning
  • Engagement and representation
  • Accountability, data and reporting
  • Service delivery
  • Research

These tools and resources are intended to be read in conjunction with Primary Health Networks (PHNs) and Aboriginal Community Controlled Health Organisations (ACCHOs) – Guiding Principles.

Many are unchanged since their original publication in 2016, while some have been added or updated more recently.


National Guidance: Initial Assessment and Referral for Mental Healthcare – 2019

It is acknowledged that this 75-page document has not been evaluated to confirm its appropriateness for Indigenous people. It refers briefly to the K5 Kessler Psychological Distress Scale for Aboriginal People, and otherwise includes no specific guidance to PHNs. It states, “The Department of Health is considering additional future work” to address this gap.

An evidence-based systems approach to suicide prevention: guidance on planning, commissioning and monitoring – 2016

Commissioned from Black Dog Institute, this guidance includes a strong focus on the distinctive needs Aboriginal and Torres Strait Islander people and communities, including advice on implementing the “systems approach” of combined interventions in Indigenous communities.
The document includes a detailed section on suicide prevention in Aboriginal and Torres Strait Islander communities, and also includes an Indigenous focus in all aspects of service planning, commissioning and evaluation.

This is a collection of guidelines for PHNs in commissioning under the flexible funding pool program, through which PHNs are expected to respond to the particular mental health needs in their regions.


Aboriginal and Torres Strait Islander Mental Health Services – 2019

This guidance sets expectations of PHNs to:

  • Jointly plan culturally appropriate mental health services for Aboriginal and Torres Strait Islander people with Local Health Networks and Indigenous communities, including ACCHOs. 
  • Commission culturally appropriate evidence-based Aboriginal and Torres Strait Islander mental health services across the lifespan and across the continuum of care, including for children and youth.
  • Include Aboriginal and Torres Strait Islander people in governance structures to ensure they can influence the commissioning of Aboriginal and Torres Strait islander mental health and suicide prevention services.
  • Ensure integration and strong referral pathways with drug and alcohol, suicide prevention and social and emotional wellbeing services as well as mainstream mental health services, to meet the needs of Indigenous people.
  • Promote a culturally competent workforce, that recognises the impact of intergenerational trauma on mental health, to deliver services to Aboriginal and Torres Strait Islander people

The guidance states that PHNs, “should not commission mental health activities that are not supported by clinical evidence or which have not in some way proven to be effective for Aboriginal and Torres Strait Islander people,” leaving open the potential to support programs that are endorsed by Elders and communities, but which may not have been evaluated in mainstream clinical trials. 

However PHNs need to focus on mental health services, according to the guidance, and “not commission broader support services or assistance which is provided through other health or non-health programmes”. 
Despite this, “holistic services incorporating a social and emotional wellbeing focus, or services linked to and building upon [SEWB] teams are in scope.”
And the guidance encourages an “innovative approach” informed by co-design with Aboriginal and Torres Strait Islander communities.

Regional Approach to Suicide Prevention – 2019

This document sets out the principles for PHNs in collaborating with Aboriginal and Torres Strait Islander communities to plan and commission culturally-appropriate suicide prevention services, integrated with mental health, drug and alcohol and other relevant services:

“PHNs are expected to liaise with local Aboriginal and Torres Strait Islander people and organisations, ACCHOs and mainstream service providers to help plan, integrate and target local mental health and suicide prevention funding. This should include liaison with services which may be involved in management of risk factors for suicide to plan referral pathways and support early identification of suicide risk (e.g. domestic violence or alcohol and other drug services). PHNs are expected to ensure that commissioned services include a focus on children and young people who may be at risk of suicide and links to services which support them.”

Joint Regional Planning for Integrated Mental Health and Suicide Prevention Services – 2018

This guidance draws on the Fifth National Mental Health and Suicide Prevention Plan to give clear instructions to PHNs about how to include Indigenous communities as a priority in their regional planning:

“The Fifth Plan is the first National Mental Health Plan to specify an agreed set of actions to address social and emotional wellbeing, mental illness and suicide amongst Aboriginal and Torres Strait Islander people as a priority. It is vital therefore that this priority should be reflected in action to develop regional plans. A regional plan is an opportunity to engage in collaborative action to identify strengths and build protective factors within Aboriginal and Torres Strait Islander populations and prevent the onset and exacerbation of mental health problems, substance misuse and other problems. It is also an opportunity to plan to achieve the vital integration and locally-led tailoring of services and pathways needed to address these problems.”

The guidance prioritises: 

  • a balance of clinical and culturally informed services, supported by staff sensitive to the impact of intergenerational trauma; 
  • a holistic approach which recognises physical health, mental health, spiritual needs and social and emotional wellbeing;
  • recognition of the need for integrated mental health, suicide prevention, alcohol and other drug and social and emotional wellbeing services and;
  • planning for a local workforce which understands these issues, trained to include culture in service provision, and sensitive to the impact of intergenerational trauma. 

Consumer and Carer Engagement and Participation – 2016

Encourages PHNs to recognise that for Aboriginal and Torres Strait Islander people, cultural connection is central to mental health recovery, and to ensure the cultural safety of Indigenous people participating in consumer co-design processes.

Stepped Care (2019)

This document clarifies that social and emotional wellbeing services can be considered part of the stepped care approach for Aboriginal and Torres Strait Islander people, and that services and referrals should be closely integrated to meet the needs of Indigenous people.

Low Intensity Mental Health Services for Early Intervention 

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

Psychological Therapies provided by Mental Health Professionals for Underserviced Groups – 2019

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people.

Primary Mental Health Care Services for People with Severe Mental Illness – 2019

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

Child and Youth Mental Health Services – 2016

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

Workforce Support Information and Resources – 2016

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

Psychological Treatment Services for people with mental illness in Residential Aged Care Facilities – 2016

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

Peer workforce role in mental health and suicide prevention – 2016

No specific guidance for meeting the needs of Aboriginal and Torres Strait Islander people

ATSISPEP and Indigenous Governance Framework Decision Tools

PHN Engagement Project

 PHN Reconciliation Action Plans

Under the Commonwealth Government’s Primary Health Networks (PHNs) and Aboriginal Community Controlled Health Organisations (ACCHOs) – Guiding Principles (2016), all PHNs should, “have in place, or be progressing towards, a Reconciliation Action Plan endorsed by Reconciliation Australia”. 

Reconciliation Australia, “promotes and facilitates reconciliation by building relationships, respect and trust between the wider Australian community and Aboriginal and Torres Strait Islander peoples,” based on five dimensions: race relations, equality and equity, institutional integrity, unity and historical acceptance.

A Reconciliation Action Plan (RAP) is a strategic document which supports an organisation’s business plan and includes practical actions to drive reconciliation both internally and in the communities in which the organisation operates, by supporting organisations to develop respectful relationships and creating meaningful opportunities with Aboriginal and Torres Strait Islander peoples. There are four tiers of RAP, representing different levels of experience of and commitment to reconciliation principles within an organisation.

In this regard, a RAP is strongly aligned with suicide prevention principles in Indigenous communities, which also emphasise Indigenous leadership and respectful relationships that acknowledge past and continuing injustices alongside strengths and capacity. A RAP is current for one year for the initial Reflect level RAP, rising up to three years for the more advanced Stretch level RAP. 

Most PHNs have completed at least one RAP, according to a review of PHN websites (September 2020). These RAPs, which are linked below, provide a resource for other PHNs as they begin or move along their RAP journey.

A Reflect RAP clearly sets out the steps you should take to prepare your organisation for reconciliation initiatives in successive RAPs. Committing to a Reflect RAP allows your organisation to spend time scoping and developing relationships with Aboriginal and Torres Strait Islander stakeholders, deciding on your vision for reconciliation and exploring your sphere of influence, before committing to specific actions or initiatives. This process will help to produce future RAPs that are meaningful, mutually beneficial and sustainable. – Reconciliation Australia


Coordinare (South Eastern NSW PHN) (June 2019 to June 2020)

South Western Sydney PHN (January 2019 to January 2020)

WentWest (Western Sydney PHN) (June 2018 to June 2019)

South Eastern Melbourne (June 2018 to June 2019)

Brisbane North (June 2019 to June 2020 – now beginning an Innovate RAP)

Darling Downs West Moreton PHN (March 2020 to March 2021)

Northern Queensland PHN (September 2018 to September 2019)

WAPHA (March 2018 to March 2019)

An Innovate RAP outlines actions that work towards achieving your organisation’s unique vision for reconciliation. Commitments within this RAP allow your organisation to be aspirational and innovative in order to help your organisation to gain a deeper understanding of its sphere of influence, and establish the best approach to advance reconciliation. An Innovate RAP focuses on developing and strengthening relationships with Aboriginal and Torres Strait Islander peoples, engaging staff and stakeholders in reconciliation, developing and piloting innovative strategies to empower Aboriginal and Torres Strait Islander peoples. – Reconciliation Australia


Central and Eastern Sydney PHN (June 2018 to June 2020)

Nepean Blue Mountains PHN (June 2018 to June 2020)

North Western Melbourne (February 2018 to February 2020)

Gold Coast PHN (February 2018 to February 2020)

NTPHN (December 2017 to December 2019)

Eastern Melbourne PHN (March 2020 to March 2022)

A Stretch RAP is best suited to organisations that have developed strategies, and established a strong approach towards advancing reconciliation internally and within the organisation’s sphere of influence. This type of RAP is focused on implementing longer-term strategies, and working towards defined measurable targets and goals. The Stretch RAP requires organisations to embed reconciliation initiatives into business strategies to become ‘business as usual’. – Reconciliation Australia


Brisbane South PHN (May 2018 to May 2021)

An Elevate RAP is for organisations that have a proven track record of embedding effective RAP initiatives in their organisation through their Stretch RAPs and are ready to take on a leadership position to advance national reconciliation. Elevate RAP organisations have a strong strategic relationship with Reconciliation Australia and actively champion initiatives to empower Aboriginal and Torres Strait Islander peoples and create societal change. Elevate RAP organisations also require greater transparency and accountability through independent assessment of their activities. – Reconciliation Australia


No PHNs have published an Elevate RAP

Some PHNs have not completed a RAP but have instead undertaken a comparable formal process of engagement and documented commitments with their Aboriginal and Torres Strait Islander communities.


Hunter New England and Central Coast PHN

Culturally Responsive Aboriginal Healthcare Framework Guide 2018-2020

Western NSW Primary Health Network

Cultural Safety Framework

Cultural Safety Evaluation Tool User Guide

A RAP is in development

 PHN Suicide Prevention Trials

This list shows all PHN-centred suicide prevention trials, supported through Commonwealth or State Governments or philanthropic funding.

Highlighted trials are focused wholly or partly on Indigenous people and communities.

National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
Central and Eastern Sydney
Northern Sydney
Western Sydney
Nepean Blue Mountains
South Western Sydney
South Eastern NSW Illawarra Shoalhaven – from August 2017

Suicide Prevention Collaborative

Western NSW

Western New South Wales Suicide Prevention Trial

Remote Western NSW, including:
– Bourke LGA
– Brewarrina LGA
– Cobar LGA
– Lachlan LGA
– Walgett LGA
– Wedding LGA- Aboriginal and Torres Strait Islander peoples
– Men in farming and mining
Youth, particularly Aboriginal and Torres Strait Islander peoples
Hunter New England and Central Coast Newcastle – from Aug 2017
(HNELHD lead)
ACCHO Awakabal is a membership of the Leadership Group
Hunter New England and Central Coast Central Coast – from Dec 2017
(Central Coast LHD lead)ACCHO Yerin is a member of Suicide Prevention Central Coast
Murrumbidgee Murrumbidgee – from April 2018

Lifespan Murrumbidgee

National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
North Western Melbourne

North Western Melbourne Trial Site

Whole PHN region

– Lesbian, Gay, Bisexual, Transgender, and Intersex (LGBTI) people, including young people
– Men

Macedon
Brimbank
Whittlesea
Eastern Melbourne Maroondah
South Eastern Melbourne Dandenong
Mornington
Gippsland La Trobe
Bass Coast
Murray Benalla
Mildura
Western Victoria Great South Coast
Ballarat
National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
Brisbane North

Brisbane North Suicide Prevention Trial

Entire Brisbane North PHN region

– Young and middle-aged males
– LGBTI people
Aboriginal and Torres Strait Islander peoples

   
Brisbane South      
Gold Coast      
Darling Downs and West Moreton      
Western Queensland      
Central Queensland, Wide Bay, Sunshine Coast

Central Qld, Wide Bay, Sunshine Coast Suicide Prevention Trial

– Maryborough
– North Burnett
– Gympie
– Men
Aboriginal and Torres Strait Islander People
   
Northern Queensland

Northern Queensland Suicide Prevention Trial

– Townsville region
– York Peninsula
– Ex Australian Defence Force members and their families (Townsville region)
Aboriginal and Torres Strait Islander peoples (York Peninsula)
National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
Perth North
Perth South

Perth South Suicide Prevention Trial

– Rockingham
– Waroona
– Mandurah
– Kwinana
– Murray– Youth
Country WA

Mid-West WA Suicide Prevention Trial

– Geraldton
– Carnarvon
– Meekatharra
– Mullewa
– Mt Magnet
– Morawa
Men aged 25 to 54 years, in particular men working in primary industry, fishermen, farmers and miners and the building industry.
Country WA

Kimberly Suicide Prevention Trial

Broome
– Bidyadanga
– Dampier Peninsula (including Beagle Bay, Lomboadina/Djarindjin and One Arm Point)
– Derby
– Fitzroy Crossing
– Halls Creek (including Warmun)
– Kununurra
– Wyndham and the Kutjunka region (including Balgo, Billiluna and Mulan)Aboriginal and Torres Strait Islander peoples
National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
Tasmania

Tasmania Suicide Prevention Trial

– Launceston
– Cradle Coast (Burnie LGA, Central Coast LGA, Devonport LGA)
– Break of Day– Men aged 40 to 64 years
– Men and women aged 65+ (sub group 65 to 74 years, sub group 75 to 84 years)
National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
Northern Territory

Darwin Suicide Prevention Trial

Greater Darwin region

Aboriginal and Torres Strait Islander peoples

National Suicide Prevention Trial – regions/priority populations NSW LifeSpan trial Victorian place-based trial
ACT ACT Health in partnership with Capital PHN – from November 2018

STORIES OF POSITIVE COMMISSIONING

Western NSW PHN Workforce Capacity Building Project

Case study for the CBPATSISP Manual of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention

Western NSW PHN covers an area of more than 400,000 square kilometres comprising four larger regional towns and areas classified as rural or remote. Service providers experience problems recruiting suitably skilled staff, especially outside of the regional centres. Fly-in-fly-out workers fill immediate shortages but do not form deeper connections with communities or solve long-term workforce issues.

Responding to this extreme workforce shortage, WNSWPHN initiated a Workforce Capacity Building project to provide scholarships and support to people who live in under-serviced communities to train as professionals.

Undertaken through the National Suicide Prevention Trial, the project recruited residents from each of six trial site Shires – Brewarrina, Bourke, Cobar, Lachlan, Walgett and Weddin – supporting them to complete a Certificate lV in Community Services. This broad qualification was chosen to maximise graduates’ employment prospects, while predetermined electives in Crisis, Bereavement Support, Alcohol and Other Drugs and Working with Aboriginal and Torres Strait Islander Communities ensured they acquired core suicide prevention skills.

The first student intake was recruited in 2017, with selection based on commitment and strong community connections. The 16 successful candidates included Aboriginal and non- Aboriginal men and women from a wide age range, including many with lived experience of suicide or mental health issues and several who had not previously undertaken study beyond Year 10.

The program was led by the Western Plains Regional Development at Condoblin, under contract to the PHN, while the Cert lV education models were delivered through the non-profit training organisation Verto. Students were based with service providers in their local regions. In three of the six shires – Walgett, Brewarrina and Bourke – this was an ACCHO.

Funding covered the employment of a part-time project officer, a computer and internet connection for each participant to support their participation in fortnightly classes by video-link, and travel costs for them to attend face-to-face meetings where they also completed short courses including Aboriginal Mental Health First Aid and ASIST and SafeTalk suicide prevention training. The program provided academic  and personal support to help students manage the pressures and ambiguities they face in undertaking study and embarking on a formal role as a worker within their own communities.

The investment in the local development of community support workers aligns with the conclusions of a modelling project undertaken by Sax Institute, also under the suicide prevention trial. The modelling found that for the Aboriginal population in the PHN catchment, assertive after-care, hospital staff training and Aboriginal community support programs could potentially avert 11% of suicide cases and 9% of attempted suicide cases over the next 20 years – much more than clinical interventions. The positive effect attributed to community programs typically delivered by the community services and peer workforces – to reduce isolation and strengthen resilience and connections to community and culture – was nearly double in Aboriginal communities than in the population as a whole.

The abbreviated commissioning cycle under the suicide prevention trial meant there was not time to co-design the program with each community as would usually be expected. However the project team gives a formal update to the PHN’s Aboriginal Advisory Council every six months and is also collaborating with the Murdi Paaki Regional Assembly and its Community Working Parties to build understanding and support for the program in individual towns.

The collegiality of the Workforce Capacity Building program has been especially important for rural students, who may feel isolated while studying. Aboriginal students benefit from strategies that address potential barriers to learning, including cost and disadvantage in school education. Their communities also benefit from witnessing their members’ success in completing higher education as well as from the skills they develop. The program has been particularly successful in increasing the number of qualified local workers in more remote communities such as Brewarrina and Lightning Ridge.

Thirteen students, of whom seven were Aboriginal, graduated in September 2019, and nine of the graduates immediately found work in the community services sector. A second intake of 15 community members began studying in late 2019, of whom nine identify as Aboriginal, and the PHN is now considering how it can fund Workforce Capacity Building to become an ongoing program.

Krurungal Community Pathway Connector Program – with Gold Coast PHN

Identifying the need

Krurungal Aboriginal & Torres Strait Islander Corporation, is a small community-controlled organisation focused on emergency relief, education, cultural safety training and connecting people to services to meet their needs, in the Gold Coast community. Krurungal is highly respected and deeply connected in the local Gold Coast community, and because of this and the diversity of its programs it is often contacted by people and families whose issues do not fall neatly within a single program category.

Recognising that Krurungal was offering essential social and emotional wellbeing support outside of program structures, the Gold Coast Primary Health Network (GCPHN) explored how it could better facilitate this work. The result is the Community Pathway Connector program, which offers clients up to four weeks of culturally safe, non-clinical engagement, with the aim of connecting people with services across the stepped-care model; meeting the needs of individual people.

Krurungal was previously commissioned by GCPHN to provide the Commonwealth Government’s Partners in Recovery (PIR) program (which ended in June 2019). Through this relationship, the GCPHN saw how the strict eligibility criteria for PIR and other government programs could restrict access for many people who most needed support. Krurungal continued to support these people, but this work went unrecorded and largely unfunded.

Co-designing a solution

The GCPHN convened a co-design workshop with Krurungal, local Aboriginal Elder representatives, other community representatives, and the GCPHN Commissioning Manager, focussing on filling this gap. Reflecting on the need, participants were clear that this should not be a crisis or case management service, but a mix of  holistic and culturally safe support and advocacy over a limited time period, to help people with complex mental health and social and emotional wellbeing needs reset their engagement with the wider service system.

They decided the Community Pathway Connectors should be a four-week program – long enough to put in place an appropriate mix of services around clients, but short enough for the individual not to become reliant on a short-term intervention program. In scope were employment, education and housing services as well as mental health and AOD, provided by the highly-skilled Kalwun Aboriginal Medical Service or mainstream services.

Resourcing for results

The next issue was how to fund the program. Most funding allocations were provided against particular programs, or with terms too strict to accommodate the Community Pathway Connector model, so the GCPHN’s psychosocial programs team requested support through the flexible funding pool intended to drive mental health reform. The team then had to convince the GCPHN executive leadership group to back the project, even though they had no data that showed specifically how the time and money would be spent.

Community Pathway Connectors began on July 1, 2019 as a one-year pilot with three staff funded through Krurungal, and one staff member through a CALD organisation. The reporting template is as detailed as for most funded PHN programs, but there is much greater flexibility in the activities that are entered in the fields. This allows support workers to – for example – record follow-up phone calls or engagement with family members as legitimate work under the program, to accompany a client to initial appointments and to liaise with mainstream providers about clients’ needs. This ensures a more accurate capture of the nature of Krurungal’s work, and gives greater insights into the needs of clients and what interventions are most helpful.

Community Pathway Connector support can also be provided at varying degrees of intensity. Some clients’ issues can be resolved in a phone call or two; others require more input, especially if staff need to resolve issues that have arisen between different service providers. Krurungal’s strong community and agency relationships generally mean such issues can be resolved efficiently.

The four-week limit ensures there is always capacity for new clients to access the program, and has proven beneficial for the staff, who take satisfaction in moving quickly on complex situations and being able to help a larger number of people. It also creates a problem-solving culture, which in turn prevents people becoming “stuck” in the system.

Outcomes

By early 2020, Krurungal had provided culturally safe and flexible connection, intervention and referral pathways for through the Community Pathway Connector program to more than 80 people aged 12 to 65 and older.

Issues and referrals have included mental health, domestic violence, cultural connection, family support, education, transport, housing and accommodation, physical health, intellectual and cognitive disability, employment, advocacy and legal issues. As well as Kalwun, Krurungal has referred clients to mainstream agencies including the Robina branch of the Queensland Department of Housing and Public Works and emergency housing provider Blair Athol Accommodation and Support Program. For the first time, Krurungal’s work in providing cultural awareness, education and support to mainstream services has been captured in the Community Pathway Connector Program data.

The Community Pathway Connector program is now developing a reputation beyond the official Gold Coast catchment, as people from the wider region’s substantial transient population and from remote locations bring their complex issues to Krurungal. There has also been liaison with agencies as far away as South Australia.

The model will be evaluated in early 2020 ahead of a decision mid-year about whether to extend its operation beyond the pilot phase.

In the meantime, the four-week, flexible approach is already being applied to address system issues for people from culturally and linguistically diverse (CALD) populations, and is under consideration for other groups including older people and those who need palliative care.

By making Krurungal’s work visible and measurable, GCPHN is funding Aboriginal-led services in a way that is compatible with how they are actually delivered, rather than forcing them into a mainstream framework.

PHN RESOURCES

PHNs have developed their own tools and resources to support the commissioning process. This is a collection of PHN resources most likely to be useful in commissioning Aboriginal and Torres Strait Islander mental health, social and emotional wellbeing and suicide prevention services.


Adelaide PHN Commissioning Framework

Western NSW Cultural Safety Framework

OTHER RESOURCES

Many other organisations have developed resources that may be valuable to PHNs in commissioning Aboriginal and Torres Strait Islander mental health, social and emotional wellbeing and suicide prevention services.

CLINICIANS & FRONT LINE WORKERS

In this section you’ll find resources that can help you look after the wellbeing of your Indigenous clients and their families, and respond in a culturally safe and appropriate way when life is going smoothly or when things are tough. These resources are intended to give you practical support no matter whether your professional training is as a psychiatrist, psychologist or other clinician, or if you are a social worker, youth worker, peer worker or volunteer.
If someone needs immediate support at a different level than you are trained for, or if you need help yourself, don’t ever hesitate to reach out to someone with the right expertise.

Heading Goes Here

These tools can help you work with communities to keep everyone stay safe, well and thriving.

Strengthening Our Spirits – Principles and Components
Strengthening Our Spirits – The Four Elements
Healing Foundation fact sheet – The Apology
Healing Foundation – Glossary of Healing Terms
Orygen – Aboriginal and Torres Strait Islander young people and Mental Ill Health
Thirrili: Defining and addressing Aboriginal and Torres Strait Islander Trauma, Grief and Post-vention

These tools can help you work with communities to promote resilience, using people’s strengths to respond to local priorities and developing skills and strategies.

Yarning about Suicide Prevention in our Community (NSW)
Words for Feelings Map (Ngaanyatjarra or Pitjantjatjara)

Losing someone to suicide can raise a whole lot of issues. These tools can help you support individuals and the community respectfully through some of the emotional and practical challenges.

BeYou fact sheets: Grief: how Aboriginal and Torres Strait Islander young people might respond to suicide
Suicide Contagion for Aboriginal and Torres Strait Islander Young People
Sad News, Sorry Business – Caring for Aboriginal people through Death and Dying (QLD)
Thirrili: Defining and addressing Aboriginal and Torres Strait Islander Trauma, Grief and Post-vention
Australian Health Infonet: Key facts – Grief, Loss and Trauma

REFERENCES

1: Parliament of Australia Accessibility and quality of mental health services in rural and remote Australia, 4 December 2018
https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/MentalHealthServices/Report/c02

NEED HELP RIGHT NOW?

If you or someone close to you is in distress, you can find support by calling one of these helplines now:

Lifeline Australia – Call 13 11 14 or Crisis Support Chat

Suicide Call Back Service – Call 1300 659 467 or online counselling

Kids Helpline – Call 1800 551 800 or WebChat counselling

Mens Line Australia – Call 1300 789 978 or online counselling

Open Arms Veterans & Families Counselling – Call  1800 011 046 or visit their website

Qlife – LGBTI peer support and referral – Call 1800 184 527 or webchat 3pm to midnight daily

The National Indigenous Critical Response Service – Call 1800 805 801

Some people may have suicidal thoughts when things are too hard and painful. With help, you can overcome these thoughts and stay safe.

If someone is in immediate danger please dial 000 as soon as possible.