Seminar notes

In context—alcohol (and other drugs) in

Indigenous communities

Professor Ian Anderson, Onemda VicHealth Koori

Health Unit, The University of Melbourne

Onemda is a Woiwurrung word for spirit, wellbeing and

love.

Professor Ian Anderson discussed alcohol-related

harm using a burden of disease (BOD) framework, and

looked at how national policy is dealing with this issue.

The life expectancy of an Indigenous person is 11 years

less than that of a non-Indigenous person.

Burden of disease analysis based on data from 2003

show that Indigenous Australians have:

Two and a half times the BOD of non-Indigenous ›

Australians

Five times the BOD due to diabetes ›

Four and a half times more BOD due to ›

cardiovascular disease

Four times the BOD and disability due to intentional ›

injuries.

The Indigenous Health Gap shows the difference

between observed BOD, and BOD for all Australians,

and included:

Tobacco–17 per cent ›

Alcohol–four per cent ›

Illicit drugs–four per cent ›

Intimate partner violence–three per cent ›

Unsafe sex–two per cent. ›

Policy context

The following were discussed:

National Strategic Framework for Aboriginal and ›

Torres Strait Islander Health 2003–2013

Council of Australian Government (COAG) national ›

framework for preventing family violence and child

abuse in Indigenous communities

National Drug Strategy Aboriginal and Torres Strait ›

Islander Peoples’ Complementary Action Plan

2003–2009

National Alcohol Strategy 2006–2009, along with the ›

Complementary Action Plan.

National Strategic Framework for Aboriginal and

Torres Strait Islander Health 2003–2013 has identifi ed

immediate priority areas including emotional and

social wellbeing (mental health problems and suicide,

the protection of children from abuse and violence,

response to alcohol, smoking substances and drug

misuse).

The policy documents contained the following common

themes:

Dealing with a complex set of inter-related issues, ›

such as social and family harm, violence, abuse and

alcohol and other drugs (AOD).

Responses include leadership and capacity building ›

within communities, community organisation,

partnerships and tailoring to the Aboriginal context.

Tackling underlying causes, such as ›

intergenerational processes, poverty and broader

social determinants of health; along with access to

health services, rehabilitation and other specialist

services.`

Recent developments

On 24 March 2008, Prime Minister Kevin Rudd, the

leader of the Federal Opposition and signifi cant leaders

in the health sector, signed a pledge to close the

Indigenous health gap by 2030, and to close the equity

gap in health service provision by 2018.

Prevention of alcohol-related harms in Victoria’s Koori Communities:Research, policy, practice and Indigenous ways of working

Free interactive seminar and forum held from 10.00am to 12.30pm on

Thursday 3 September 2009, Aborigines Advancement League, 2 Watt Street, Thornbury

The National Indigenous Health Equality Council was

established in July 2008, and draws membership from

Australian Government and the Aboriginal and Torres

Strait Islander community. Its aim is to provide advice on

commitments made under the March 2008 Statement of

Intent on achieving Indigenous health equality.

COAG targets include:

Closing the life expectancy gap in a generation ›

Halving the child mortality gap in ten years ›

Halving the literacy and numeracy gaps ›

Halving the employment gap within a decade ›

Halving the gap for Indigenous students in year 12 by ›

2020

Providing access to early childhood education for all ›

four year olds in remote Indigenous communities, in

fi ve years.

Prevention of alcohol-related harms in Victoria’s

Indigenous communities

Karen Milward, Indigenous Business Consultant

Karen Milward gave a presentation of her DrugInfo Issues

Paper, “Prevention of alcohol-related harms in Victoria’s

Koori communities”.

Problematic alcohol consumption is a major contributor

to the poor health status, social problems and shorter life

expectancy of Australian Indigenous people.

The Issues Paper considered the views of key informants

with professional experience in providing services to

Koori people, combined with a literature review, to identify

issues impacting on alcohol-related harms in Victorian

Koori communities, and service response options

available in Victoria.

Victorian research showed that in Department of Human

Services (DHS) treatment services in 2003:

57 per cent of Indigenous clients were receiving ›

treatment for an alcohol-related issue

Multiple drug use was an increasing trend in Koori ›

communities

Alcohol and cannabis were commonly used together ›

Injecting equipment was commonly shared by injecting ›

drug users, resulting in a high risk of transfer of blood

borne viruses.

The literature review showed:

Victorian Indigenous women identifi ed alcohol as a ›

major cause of violence and chaos in their lives.

Aboriginal people use community-based AOD services ›

at 14 times the rate of non-Aboriginal people.

In 2006/7, about 2100 Aboriginal clients received ›

almost 4000 courses of AOD treatment.

People admitted to hospital for alcohol-related ›

conditions are generally older than those admitted for

other drug-related conditions.

Aboriginal people were admitted to hospital for AOD- ›

related conditions more often than non-Aboriginal people.

Males are admitted at approximately twice the rate as ›

females.

Those between the ages of 25 and 64 have higher ›

numbers of admissions per person than older or younger

people.

Mental disorders

Koori people traditionally perceive their health in terms of

physical health, as well as the social, emotional and cultural

wellbeing of their community. For this reason, a holistic

approach to treatment is necessary.

Emotional and social diffi culties, such as depression, suicide

and AOD abuse are huge issues in Koori communities. Mood

disorders can be set off by stressful events or situations.

Mental health-related problems are a frequent cause of

hospital admissions for Koori people in the 15 to 44 year age

group.

Victorian hospital admissions data

Renal failure is the leading cause of hospitalisation for

Aboriginal people. Other frequent causes of admission

include respiratory diseases, mental health problems,

circulatory disease, pregnancy and cancer (in the 55+ age

group).

Data are available on hospitalisations due to self-harm,

AOD misuse and mental health conditions, but are likely

to underestimate the actual number of Aboriginal people

admitted to hospital. Those aged between 30 and 44 are the

most likely to be admitted to hospital.

Main conclusions

Alcohol-related harm in Victoria’s Koori communities is ›

a hidden problem, as there are currently few sources of

specifi c, accessible data or information about the extent

of the problem.

It would be helpful if Koori-specifi c data could be shared ›

with internal and/or external stakeholders, so that we

can fully understand the impacts of alcohol in these

communities.

Alcohol-related treatment and hospitalisation is usually ›

accessed by Koori people outside the region where

they live. This is not surprising as most Koori people live

outside the Melbourne metropolitan area where most

services are located.

Action taken in this area will also address violence and ›

poverty experienced by Koori communities.

Services must particularly assist individuals who have ›

More information

For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on

tel. 1300 8585 84, email druginfo@adf.org.au, or see our website www.druginfo.adf.org.au

an addiction to alcohol, but lack family support and

personal strength to seek help for their problem.

More research on AOD-related hospital admissions is

needed to identify the appropriate actions to be taken to

prevent alcohol-related harm issues.

Case study 1: Ngwala Willumbong & Youth

Substance Abuse Service program

Glenn Howard, Program Coordinator, Ngwala

Willumbong Co-operative Ltd

Glenn Howard gave an overview of the development

of the Koori Youth Alcohol and Drug Healing Service,

a residential drug and alcohol program, which is a

partnership between Youth Substance Abuse Service

(YSAS) and Ngwala Willumbong.

The project plan consisted of three phases:

Phase 1: Development of the service model and ›

operational guidelines, and the establishment of a six-

bed interim service.

Phase 2: Establishment of a 12-bed, purpose-built ›

facility, and transfer of the service to this site.

Phase 3: Transition of the service to Ngwala within ›

four years.

The project began with the lease of a large property in

Bittern, Victoria. The team faced opposition from local

residents, but with the support of local government

and police, the project went ahead, a team of staff was

employed, and the fi rst young people began to participate

in the program.

Respect for each other’s systems, open communication

and inclusive decision-making processes were vital in

building the successful partnership between YSAS and

Ngwala Willumbong. Friendship, trust, willingness to

learn and change, and shared belief systems were also

considered to be important.

Aerial photographs, maps and a virtual tour were

presented to show the site and layout of the fi ve

acre block. The permanent facility will include two

accommodation units, meeting area, administration

building, communal building, gathering area, fi re pit,

cultural space and basketball court.

The buildings are a blend of colourbond, glass and

cement. Cultural elements will include internal art works.

The design has a universal approach, aimed to appeal to

young people.

Case study 2: Warrakoo Program

Sandi James, Drug and Alcohol Counsellor, Mildura

Aboriginal Health Service

Sandi James discussed the Warrakoo Transition Centre,

located 120 kilometres from Mildura, where she has

worked for almost three months.

Originally a diversionary program for young Aboriginal

people charged with substance misuse offences, the

program now services adult Aboriginal men who have

substance misuse problems, and may also have additional

problems, such as legal issues. Participants may be

voluntary or referred by the court.

Warrakoo is run by the Mildura Aboriginal Health Service

(MAHS), which is part of the Mildura Aboriginal Corporation

(MAC), and is a member of the Victorian Aboriginal

Community Controlled Health Organisation (VACCHO).

A new, structured program of work and activities is

currently being devised for Warrakoo clients. This

will include farm work, one-on-one counselling,

group programs, psycho-educational groups, anger

management/self esteem workshops, TAFE programs and

a living skills program.

Therapies will include narrative therapy, mindfulness and

cognitive behavioural therapy. All programs will have a harm

minimisation focus, remembering that not all clients will want

to be abstinent when they leave the service and will need

self management and help-seeking skills.

Further programs to be offered include day workshops and

programs for men’s and women’s groups, short camping

trips, and access to distance education or literacy programs.

Clients have access to a general practitioner, nurses, a

dietitian and Aboriginal health workers who travel out to

Warrakoo. There are also a range of services including

dental treatment and eye health screening, which are

available at MAHS.

The service faces a number of diffi culties, many of which

are due to the remote location of the service. For example,

clients usually need to travel long distances for residential or

hospital-based detox, and many are reluctant to be too far

away from their family and community.

It is diffi cult to attract and retain trained staff due to the

isolation of the property, and counselling can currently only

be offered on a fortnightly basis because of a lack of MAHS

staff, and time available, to travel out to Warrakoo.

A range of activities are underway to develop the service.

At the moment, all Warrakoo staff are in the process of

gaining their Certifi cate IV (Drugs and Alcohol), networks

are being formed with other services and training

pathways are being investigated so that community

members can be involved in more health and education

activities. These initiatives will all contribute to good health

outcomes for the community.

More information

For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on

tel. 1300 8585 84, email druginfo@adf.org.au, or see our website www.druginfo.adf.org.au

More information

For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on

tel. 1300 8585 84, email druginfo@adf.org.au, or see our website www.druginfo.adf.org.au