INDIGENOUS

According to the United Nations, the ‘gap’ in life expectancy between Indigenous and white Australia is the biggest indigenous gap in the world, has been for some time. Hovering around 20-23 years of lost life it represents a national healthcare crisis. I am a psychologist with a 100% Indigenous client base. I can tell you with twenty-five years of authority and expertise that the failure of The Voice was a lost opportunity to get the real story on the table, to get the data right, to explain the gap, and finally close it. I work in the prevention of Indigenous suicide and violence, counseling for trauma and mental health treatment — and I’ve directly witnessed my clients regress in their therapy from this outcome. With regularity we are saturated with headlines of statistics upon statistics telling a seemingly endless trail of horror.

• Of Indigenous suicides double that of non-Aboriginal Australia.
• Of child suicides six times that of non-Indigenous children.
• Of child removals 11 times the rate.
• Incarceration of our youth at 24 times the rate.
• Adults at 19 times.

And on it goes

There is no dressing up these statistics. Frustratingly, the gaps are as evident and unacceptable as they are easily corrected and there are just too many lives being lost by this failure while governments continue to throw good money after bad. 

The first thing that needs urgent attention is we need to get the data right. It is a literal mess across multiple fronts and is the sole cause of the unabated escalation and ongoing poor outcomes. The absence of critical data has made it impossible to appraise prevention efforts or to ensure targeted, needs-based funding allocation and accountability. We continue to track demographic data and trends only (on child removal numbers, suicide deaths, incarceration numbers), hoping it will provide some magical insight into how to solve these issues. But the simple reality is that we have yet to analyse data in a way that determines unique causal pathways. This would ensure focused, targeted treatments and interventions. We are also not tracking any outcome, but we are tracking output (bums on seats; services delivered). And in many instances, we do not have any baseline data against which to determine if critical gaps have actually been closed.

Instead, we just track demographic data, wring our hands over the latest headlines, and fail to explain how to address any of it. Explaining why Aboriginal people continue to be so overrepresented in these statistics has never been a focus and it needs to be. Answer that and treatment and intervention become focused on the actual causes, and this reduction becomes our sole focus and outcome metric against which accountability is king. Yet there is not one government-funded program in Indigenous suicide prevention, justice and child protection that has demonstrated risk reduction. Staggeringly, funding does not require that programs demonstrate a measurable reduction in risk factors in the communities in which they are being delivered. You cannot find any national database on outcomes across any of these critical areas to justify the expenditure. 

We have long known that programs that target established risk factors provide our best opportunity of preventing suicides, incarceration and child removals, rather than general awareness programs; but we fail to apply this basic scientific standard to our most vulnerable communities. Instead, the bulk of this critical funding continues to be diverted to ‘reviews upon reviews’, ‘roundtables’, ‘conferences’ or ‘resource data bases’ — nothing that focuses on targeted prevention programs despite these having shown evidence of reducing risk in our highest risk offenders, our highest risk suicidal individuals, highest risk families.

In suicide prevention, as just one example, we have had $9.5 million in reviews since 2016. Reviews which have, failed to find one program in Australia that falls into the category of targeted intervention. I published on the first ones in 2020 which I have not been able to deliver in over ten years due to a complete absence of funding. This is politics. This is what happens when the funding mindset is subjective rather than data determined and objective. Indeed, accountability has never been central to decision-making; it is always unfairly blamed failure to close the gap at those at the coal face, those who have little to no influence on funding. Instead, too many people who sit on advisory committees are disconnected from the reality; with no pre-requisite training or track record in working clinically with at-risk Aboriginal clients or delivering outcome-based prevention programs into (usually remote) high-risk Aboriginal communities. When you are making zero traction on suicides, child removals, incarcerations and they are escalating each year and you have the same people at the helm continuing to quarantine all of the funding there is no reset, no questioning of the outcomes.

Ensuring access to our highest-risk, most vulnerable communities — like Alice Springs, Cherbourg, the Kimberley, and Walgett — has never been understood, which is why data geomapping is one area that is critical to closing the gap. These communities are so identifiable, the fact governments have failed to mobilise critical resources into them should be our constant accountability narrative. Instead, we see significant amounts of money for career consultants to rehash literature reviews, develop promotional pamphlets, videos or databases that ultimately recommend the same programs or recommend more reviews that tell us ‘what the problem is’ or how the problem should be ‘re-conceptualised’ with another ‘framework’ or infographic. There is clearly comfort in talking to the same people and currency in jostling to be a key advisor and this has become entrenched. Governments do not engage in subject matter expertise beyond their selected ‘advisors’. So, there are no answers beyond a closed ideology — an echo chamber of the same ideas confined to a handpicked selected group.

As someone who is all about prevention, as a psychologist from a remote region, as an Aboriginal person and tax-payer to boot, it’s been extremely frustrating to watch a national ‘groundhog day’ on repeat every year, particularly when it is about people’s lives. I don’t expect politicians to be across an issue this complex, but I do expect they are concerned with applying the best possible science and insist on transparency from advisors around conflicts of interest. And yet, here we are. And we will remain here if we don’t completely change focus towards the evidence and not towards the self-congratulatory opinions of the over-funded few.

So where are the gaps?

Despite horrifying statistics, we have no national Indigenous mental health prevalence data nor are we capturing this regularly. So, we do not know how much trauma there is in Aboriginal populations, how much depression or suicidal behaviours.

The World Health Organisation has long advocated that the best method of reducing the burden of disease is to first, as in day one on the job, ‘define the problem’. If you are not measuring a gap, how can you close a gap? The failure to have any information on the nature, extent and prevalence of mental ill health and suicidal behaviours has substantial implications including:

We have no capacity to measure whether a gap is increasing or decreasing

We have no ability to argue for a workforce commensurate with need by identifying our most disproportionally impacted communities, which are usually the most remote

We have no capacity to measure program and treatment outcomes or develop robust data on what is working, and most critically

We have zero opportunity to be proactive around early intervention and target early signs of distress (e.g. depression rather than suicide).

This is our most urgent priority; because, arguably every major gap target has mental health underlying all of it as causal — child removals, incarcerations and, of course, suicides. Yet millions funnelled into non-Indigenous led organisations who churn out reports that either completely exclude Aboriginal people from the study or make sweeping generalisations about the mental health of Aboriginal people based on ‘sampling a few Aboriginal people’.

Suicide prevention gaps

When an Aboriginal child dies in this country 40% of them will do so by suicide. Child and suicide clearly do not belong in a sentence. I have looked into the eyes of too many parents who have lost children to suicide as a psychologist, gone to too many funerals. Its’ something that never leaves you.

In 2019 we had a heartbreaking spate of suicides across the nation and the 13 deaths by suicide of Aboriginal young people in the Kimberley which has a rate estimated at seven times that of non-Indigenous Australia (around 70 times for Aboriginal men). It has for decades been a suicide hot spot. Yet there is nothing on the ground that meets the definition of suicide prevention; just four successive government inquiries, the most recent of which was the Fogliani Inquiry, all while suicides continue to escalate in that region every year. There is clearly significant currency in having government inquiries.

It also buys the government ‘time’ while they consider the latest inquiry — the WA Government took 13 months to respond to the Fogliani Inquiry after the inquiry itself took 18 months. During that time, six more young Indigenous people died by suicide.

I broke down the governments ‘$268M response’ and it was clear that they did not fund anything that resembled suicide prevention. Yet, despite this national crisis, suicide was not even in the close the gap targets until 2020. There was and remains no coherent strategy attached to getting us to the ‘zero suicide’ aspiration.

What it says to bereaved Indigenous families though is that ‘suicide prevention is not a priority’ for us nationally and reflects the lack of public attention to the fact that we have children as young as 10 in our own backyards who are choosing the option of death instead of life. Related to that has been the lack of any political will to make it a priority. In the 18 months of the Fogliani Inquiry there was not one question asked in the upper or lower house of the WA state parliament about that inquiry including what was to be done about it. Our children’s lives deserve more than silence.

With incarceration the gaps get worse

First, we have no data on why Aboriginal kids are in prison. We know what they are being charged with police by but not what crimes they are being convicted of. So, there is danger in quoting ‘youth crime statistics’ because they ‘re not convictions; they are police charges ‘proceeded’. We do know that around 86% of kids are in prison on remand (not charged with a crime) and ultimately 40% of those kids when they get in front of a magistrate are not convicted of a crime.

This is a significant human rights issue that fails to generate public concern because it is predominantly Aboriginal kids who are being held on remand and for an average of 71 days without conviction. Local police data is almost impossible to access and we do not break youth crime data down by Indigenous status. Rather, there is instead reliance on heavily compromised local police ‘data’ which seems replete with evidence of racial profiling and other race effects as factors driving the erroneous charging of Aboriginal and black people generally. Australia incarcerates ‘black’ people at the world’s highest rates; six times more than during South African apartheid and 2.3 times the rate of African Americans. With black children it gets even worse, which means that these statistics will worsen for future generations.

Sadly, we simply do not have the type of research we need on the ‘other race effect’ in Australia and must rely on US findings, where they have robust data on the extent to which ‘blackness’ influences convictions. Simply looking ‘more black’ results in four times the death penalty likelihood for the same crime despite 41% of those on death row being exonerated from DNA evidence against the eye witness testimony of white people. Not having this data means that there remains this view that the system ‘has it right’- there is no racism. But what this actually results in is a concretised narrative that Aboriginal people are somehow more predisposed to being criminals than white people. Called the ‘racial empathy gap’, we fail to relate at a human level that we are putting children in prison. In 2020. I wrote an opinion piece on raise the age and ended it with this:

A child at 10:

• Loses 4 baby teeth a year
• Knows the complete date
• Can name the months of the year in order
• Can read and understand a paragraph of complex sentences
• Has developed skills in addition, subtraction
• Has some skills in multiplying and division,

And, in Australia, can go to prison. I witnessed daily realities of children stealing food because they are hungry and being imprisoned for it during my years as a welfare worker — so called “criminal activity” was all too often about survival. We then have the reality of the ‘other race effect’ in which too many kids were pleading guilty to crimes they had no idea they had committed because ‘the copper said I did it, so I must have’.

The ‘punishment should fit the crime’ but what is the crime?

Arguments against RaiseTheAge land at this idea that there are many serious crimes that require children being locked up despite having little information on what percentage of crimes are at the serious end. Although international evidence tells us these constitute 0.5% of all child crimes, there has never been a child under 13 commit homicide in Australia. But if you were to believe some commentators you would think that this is the standard. We do know, that in NSW, for example up to 37% of youth charges by police are the result of fare evasion and up to 30% of convictions for Aboriginal people are for ‘good order’ offences. The irrefutable science tells us the earlier you incarcerate a child, the greater the likelihood they will have a future path to criminality, with 94% of young people going back to prison before they turn 18 and 45% of adults returning to prison within 2 years of release. Given it costs $500,000 a year to keep a child in prison, if you diverted that significant sum to prevention rather than incarceration, you would only need a 6% success rate to justify the expenditure.

But without data, it makes it difficult to determine trends in youth crime, develop programs specific to these needs, geomap youth crime hot spots, track local police responses, court outcomes and harsh sentencing. None of this currently occurs in a way that holds systems accountable. Instead, it becomes an annual data reporting exercise used to argue for more policing and harsher responses. Australia now has the fifth most expensive prisons in the OECD; the seventh fastest prison spending growth rate, and more police per capita. Corrective services in WA for example has a $1.1 billion budget and $900 million is spent on prisons and taking care of prisons.

As an Indigenous psychologist who has dedicated decades to prevention efforts, the core of my argument is that locking children up is ineffective as a crime prevention measure. So, the ‘tough on crime’ approach is having the reverse effect. Far from being ‘soft on crime’ or a ‘bleeding heart’ I simply ask that the best available evidence should direct us when issues this emotional are at play. What is being lost in this debate is that RaiseTheAge will force governments to invest in real crime prevention rather than blame-shifting.

Geomapping those most in need

Based on the statistics alone; more than 80% of Aboriginal families are doing very well but this is never the story.  Most of us will never come into contact with the justice system, with the child protection system, but for those who do, they carry the greatest burden. This has now become generational. If you go into any high-risk community there would be 10-15 families at most that are taking up all of the service provision and they make up the bulk of the statistics. If you work in the industry for long enough eventually one of your client’s children will become your client. We are seeing this emerge as ‘generationally incarcerated’ cohorts of families in every district, every region, who make up the bulk of the child protection and crime statistics and we also know that this is often the trajectory to suicides and mental ill health. 

The way we collect data and analyse it ensures it fits a politically convenient view of a problem that is ‘unsolvable’ and bigger than it really is.

Geomapping data would involve sharing national information across jurisdictions with data-linking technology. There are certainly good examples of this with the AIHW developing a national data set for child protection data and NSW study on data linking children across justice, mental health and child protection systems. However, if we did this nationally and across mental health, suicides, crime and child protection systems based on treatment outcome that coded families and regions, it would reveal the actual number of impacted families, individuals and communities.

When you dig a bit deeper; data from the NT shows of the 25,500 notifications of child abuse, 71% involved children already in the system (Territory Families Annual Report, 2019-2020; Territory Families, Housing and Communities, 2022). Moving to the NT, 92% of kids in care are Indigenous, which gives some much-needed perspective to the Jacinta Price and Peter Dutton argument that we need to ‘remove more Aboriginal children’. Based on these statistics, it’s impossible to remove more Aboriginal kids; it’s literally been done to death but being lauded as ‘innovative and practical’.

In child protection, removals are significantly higher in regions with the highest proportion of Aboriginal people per capita. In WA, for example, the Kimberley stands out again with 100% of children in out-of-home care identifying as Aboriginal; the Pilbara 96%; the Goldfields 87%; Murchison 86%. However, if we remove these four regions, which are the most remote and the most densely populated Aboriginal regions, (Australian Bureau of Statistics, 2022) out of the 17 child protection districts in the state, Aboriginal child removals fall from 57.18% to 39% (Department of Communities, 2021).

When it comes to youth crime, there are approximately 949 kids in prison on any given night across the whole of Australia with approximately 617 of those Indigenous. If they geomapped data they’d find this 617 are the same kids in around 80-90% of cases and I would hate to think how many of these are also in the child protection system.

It seems counterintuitive that when you are in the majority, you are more, not less, oppressed. Similarly, South Africa had apartheid when 80% of South Africans were black. It speaks to individual and group-based oppression when government-enacted legislation decrees ‘initiatives’ like cashless welfare cards and alcohol restrictions that cover whole communities based on the profiling of a smaller minority. The NT intervention engenders ‘learned helplessness’ in the face of statutory organisations who have historically wielded considerable power over remote Aboriginal communities. Since its inception, the NT has seen a 160% increase in suicides. If you paternalise people based on cultural identity this concretises learned helplessness which has been consistently shown to be one of the strongest predictors of poor behavioural outcome and particularly suicides. Geomapping data would enable us to determine the number of people involved across multiple systems and focus our prevention efforts on those most vulnerable in larger communities — those that are over-represented. The NT, for example has been calling for needs-based funding for some time. 

Implicit bias feeds the racist narrative

Implicit bias, now measurable, creates differential activity in the amygdala — a brain region selectively responsive to perceived threat (Davis, 1992; Whalen, 1998) — in response to black, compared with white, people (Hart et al., 2000; Wheeler & Fiske, 2005). These differential patterns of activity in the amygdala are thought to reflect relatively automatic threat responses to black people. The other race effect makes it more likely that an extreme narrative about the broader Aboriginal community is readily believed as factual, despite evidence to the contrary. One distorted and factually incorrect idea is that child sexual abuse and child rape are normal and rife in all Aboriginal communities. This results in discussions also being extreme. By contrast we know that 7.3% of all abuse in Aboriginal communities is sexual abuse compared to around 10% in non-Indigenous communities (AIHW, 2022). Yet it becomes easy for the public to demonise whole communities –whole towns– because of the ‘othering’ that occurs when cases of sexual abuse in an Aboriginal community are reported as if normative (Westerman, 2022; Pedersen & Walker, 1997). Significantly, 79% of notifications of child abuse in Aboriginal populations are based on ‘neglect and emotional abuse’ (AIHW, 2022), warranting an intensive family support response rather than a removal rate 11 times higher. The racial profiling of Aboriginal families shows over 60% of notifications are ultimately found to be false (Yoorrook Justice Commission, 2023). Sexual abuse disclosures in communities have then been found to be significantly lower than portrayed in the media and historically have found non-Indigenous perpetrators. Indeed, the federal police have never found a case of an organised paedophile ring orchestrated by Indigenous offenders like we have seen in the central coast of NSW by non-Indigenous offenders. 

Hey government; this is what you do — a step by step guide!

Step 1: Develop robust data to define the problem and identify our highest risk communities and families. We are doing this at Jilya and will continue this for the next three years via some philanthropic research funding.

Step 2: Once identified and/or developed, I would then geomap the data in communities that make up the bulk of the statistics. For suicides, it has always been the Kimberley region for close to three decades. Other hot spots include Cherbourg and the top half of NT. 

Step 3: Determine unique causal pathways to inform unique intervention program development and best practice treatments. We have digitised a measurement tool, the WASCY/A, for tracking continuous, rather than categorical, risk reduction (by contrast, categorical data such as suicide deaths and child removal numbers does not allow continuous tracking). 

Step 4: Mobilise selected and targeted interventions into the highest risk communities using ‘train the trainer’ level. 

Step 5: The final piece of the puzzle is to continue to develop capacity in our highest risk communities through our practitioner scholarship program. We already have five coming from the Kimberley. This year we have announced three specifically for Alice Springs. We will then move to Cherbourg, then Walgett, and so forth. If we had 30 indigenous psychologists in Alice Springs, we wouldn’t be talking about the ‘issues in Alice Springs’ for much longer. 

Step 6: Evaluate all of the above by tracking treatment outcomes

So to break it down into small chunks, this is where ‘close the gap’ will truly close. This is our focus at the Jilya Institute.

We will do this in the Jilya Institute through my donated programs — the only programs that have shown whole-of-community suicide and mental health risk reduction. They are donated so that we can develop them into ‘train the trainer’ level and upskill high-risk communities. I am proud that at Jilya we are getting it done without any government funding. It is self-determination in action. The fact that I am from a remote community myself means that becoming a psychologist becomes possible for those, like me, who come from no generational, educational or financial advantage. My students all represent our community and its potentiality. They show what is possible to every kid from their own remote communities, and all of their stories are absolutely compelling. 

Getting it done!

Activism is hard, but black activism in Australia is even harder. It requires that you motivate whole populations on issues that impact just 3% of the population. Equality will always be a challenge when it remains the responsibility of the oppressed, those with the least power, the least privilege to fix a problem created by the oppressor. Leadership, to me, means that you take a stand for others more than for yourself. It is about integrity over self-interest and the talent that you nurture because of it. But ultimately bravery is the most important of all of the leadership virtues, for it enables all of the others. Changing systems requires bravery, doing what is right over what is popular requires bravery — being brave enough to take the personal hits so the next generation doesn’t have to requires bravery.

I wish we had more leaders in this country, who were brave.