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National preventive health strategy must provide healing for Indigenous communities

National preventive health strategy must provide h
Photo: Indigenous community
The Healing Foundation is urging the Government to ensure healing is part of the National Preventive Health Strategy (NPHS) to address trauma and its accompanying health effects on Aboriginal and Torres Strait Islander people.

In its submission to the NPHS, The Healing Foundation highlights the absence of any support for Stolen Generations survivors, who experience alarming and disproportionate levels of adversity across key health areas.

A comprehensive prevention strategy is needed to address the inevitable health effects of intergenerational trauma on the children and grandchildren of Stolen Generations survivors.

The Healing Foundation CEO Fiona Petersen said supporting intergenerational healing is one of the most significant preventive activities that can be taken to mitigate the often compounding and overwhelming health impacts of trauma and must be included in the strategy, which is due for completion by March 2021.
“Evidence from the Australian Institute of Health and Welfare (AIHW) paints a picture of complex needs for the Stolen Generations, who suffered profound childhood trauma when they were forcibly removed from their homes, isolated from family and culture and often institutionalised, abused and assaulted,” Ms Petersen said.

“Stolen Generations survivors have significantly poorer physical and mental health and are more likely to report chronic health conditions such as heart disease and stroke.

“While appalling, this level of disadvantage should not come as a surprise. If people don’t have an opportunity to heal from trauma, they’re likely to live in a state of distress, which can lead to a range of negative outcomes including poor health.”

AIHW analysis also shows the extent of intergenerational effects of removal on descendants of Stolen Generations survivors.

“Children of Stolen Generations survivors may experience difficulties with attachment, disconnection from their extended families and culture, and high levels of stress from family and community members who are dealing with the impacts of trauma,” Ms Petersen said

“This can create developmental issues for children, who are particularly susceptible to distress at a young age. It creates a cycle of trauma, where the impact passes from one generation to the next.”

For example, compared to other Aboriginal and Torres Strait Islander adults, adult descendants of Stolen Generations survivors were, in 2014-15:

  • 1.9 times as likely to be a victim of threatened or physical violence in the past 12 months\
  • 1.6 times as likely not to have good health 
  • 1.5 times as likely to have experienced problems accessing services in the past 12 months
  • 1.4 times as likely to have poor self-assessed health
  • 1.3 times as likely to have poor mental health.

Ms Petersen said there is also an urgent need for the ongoing provision of meaningful support for Stolen Generations survivors because this is the last chance to do something substantial for remaining survivors in their lifetimes – many having already passed away.

According to AIHW data, compared to other Aboriginal and Torres Strait Islander people of the same age who were not removed, Stolen Generations survivors were, in 2014-15:

  • 3.3 times as likely to have been incarcerated in the past five years
  • 1.7 times as likely to have been a victim of actual or threatened physical violence in the previous 12 months
  • 1.6 times as likely not to have good health
  • 1.6 times as likely to have experienced homelessness in the past 10 years
  • 1.5 times as likely to have poor mental health.

Recommendations

The Healing Foundation strongly endorses a health equity agenda that creates and builds an early intervention approach that targets risk factors of prevention.

The Healing Foundation also supports the centrality of culture and cultural knowledge, and recognition and responses to the cultural and social determinants of health.

The Healing Foundation recommends: 

  • a focus area on healing to address trauma, given it is so fundamental to the future wellbeing of Aboriginal and Torres Strait Islander people experiencing intergenerational and collective trauma
     
  • trauma aware healing informed approaches across all policies, programs and service models – including workforce planning
     
  • leadership, collaboration and coordination across all levels of government, the non-government sector and, most importantly, Aboriginal and Torres Strait Islander people to promote and support trauma informed and healing aware policies, programs and services at the community level
     
  • co-design of policy and programs and investments in community-led services and healing programs that are supported over the long term, and with self-determination becoming a reality for Aboriginal and Torres Strait Islander communities
     
  • a strong evidence-base with a commitment to co-evaluation that informs and empowers local decision making, government investments and policy and programs, and which enables regular public reporting of outcomes.

The Healing Foundation also highlights that, due to the intertwined nature of the needs of ageing Stolen Generations survivors, urgent action is also needed to establish specific programs to address the complex requirements to support those survivors.

Background

The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by actions like the forced removal of children from their families.

Under the leadership of our Board and the Stolen Generations Reference Group, we support evidence-based healing programs and aim to create an understanding of the historical legacy of trauma and its manifestation in communities today.

We support the intention to incorporate the social and cultural determinants of health in the Strategy, and to reflect the reform areas articulated in the Closing the Gap refresh. We also endorse the positioning of culture as central to any framework that is to be trauma aware and healing informed. We also acknowledge racism as a barrier to good health and wellbeing.

The Strategy is an important opportunity to ensure programs and service models adopt trauma aware healing informed practices. Without this, many well-intentioned interventions and investments will continue to have limited effect.

The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to heal trauma caused by the widespread and deliberate disruption of populations, cultures and languages over 230 years.  This includes specific actions like the forced removal of children from their families.

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