Australia’s health system needs an overhaul to stamp out institutional racism that deters Indigenous people from getting treatment before it’s too late, according to one of the authors of a recent suicide prevention report.
“Our people aren’t going to preventative services but we are turning up in really astronomical rates in emergency departments for mental health issues,” said Professor Pat Dudgeon, a Bardi woman and expert in Indigenous mental heath at the University of Western Australia.
“Because of the unwelcoming environment people don’t feel like they can access help and even if they did, they don’t feel, obviously, that the helps going to be any good.”
Professor Dudgeon co-authored the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project report, Solutions that Work: What the Evidence and Our People Tell Us, released last week.
The Federal Government commissioned the report and said it provided a new blueprint to improve suicide-prevention services and programs for Aboriginal and Torres Strait Islander people based on community-led, culturally-appropriate services.
One section of the report deals with racism within Australia’s health systems, including high rates of “interpersonal racist actions” from health services staff.
The report said these actions contributed to an institutional barrier to Indigenous people getting help.
Signs of a system not working for Indigenous people included different hospital outcomes for Indigenous and non-Indigenous people, and the 10-year life expectancy gap between the two groups.
The report said a lack of funding for Aboriginal community-controlled health services contributed to the problem.
Professor Dudgeon told National Indigenous Times this week that it was a big challenge for Australia and the issues needed more investigation.
“Racism is still an ongoing issue in society and it does contribute to Indigenous ill health whether it is institutional racism or other kinds of racism,” she said.
“Direct racism can make people feel like they are second class human beings.
“But institutionalised racism is a product of colonisation and that keeps Indigenous people out of jobs and keeps them poor and so on.
“We feel strongly about it in any case but we also had to honour what people had said in our round tables. That was a big issue that came up over and over again.
“So social determinants, particularly racism, is an issue. We have to address it but it’s not a lightweight topic where you have a little discussion about it.
“It’s a big challenge for white and black, for Australian society. I think we are grappling with it, but a lot of the Aboriginal leadership groups have expressed concern about racism and it is alive and well.
“It is still a part of people’s everyday lives whether it is direct racism, institutionalised racism or cultural racism.”
Professor Dudgeon said in the case of mental health, Indigenous people feeling they were able to seek help at an early stage could make a big difference.
“I think the solution is to provide more Indigenous-led services and programs, but we also need to ensure the mainstream services also take responsibility in making sure their services are culturally appropriate,” she said.
“It could be a range of things. If there was a new service starting up I’d get some reconciliation action plan and elements could be to ensure there are Aboriginal people on the boards, to ensure there is employment of Aboriginal people, make sure non-Indigenous staff go to cultural confidence training.
“Look at the physical appearance of the service. Just simple things like an Aboriginal painting or a poster up on the walls indicates to people ‘you are welcome here, we value your culture’.
“There’s a whole range of things any service can do to make them more culturally welcoming.”
The launch of the report was attended by Federal Health Minister Sussan Ley, Minister for Indigenous Affairs Nigel Scullion, and Assistant Minister for Health and Aged Care Ken Wyatt.
Ms Ley said the Government had worked closely with the report authors — a team led by Professor Dudgeon, Professor Jill Milroy and Professor Tom Calma — to ensure its recommendations could be implemented quickly.
“The Coalition Government has committed to trialling the community-led approaches recommended in the report,” she said.
Professor Dudgeon said she was pleased with the way the report had been received but wanted to see what happened next.
“I am absolutely delighted, but we’ll see how it gets implemented,” she said.
“Whether they will just cherry pick some recommendations and not others. I think we need to start talking about an implementation plan for it.”