Disability services for Indigenous people must be culturally appropriate, respect kinship structures and embrace holistic understandings of health, the CEO of the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) has told a national summit.

Delivering the keynote address at the National Disability Summit in Melbourne, Dr Jill Gallagher warned that mainstream systems are failing First Nations communities and leaving many people without proper care.

"The majority of First Peoples with disabilities live in poverty. They lack access to disability appropriate housing and they lack the support they need to participate in the cultural life of their community," Dr Gallagher said.

"Many young Aboriginal people with disability cannot attend school or can only participate in a very limited way because their local school cannot accommodate their disability."

She also described the "disturbing" and "ongoing" situation of "indefinite detention" of Indigenous people with disabilities in Australian prisons, particularly in the Northern Territory, Western Australia and Queensland.

"This predictable path is preventable," she said, pointing to the need for early, culturally responsive interventions and diversion into therapeutic, community-based services to break the cycle of over-policing and incarceration.

Racism, Stigma and Justice

Dr Gallagher argued it is "vital" that First Nations understandings of both "disability" and "impairment" underpin support for Aboriginal people with mental and cognitive disabilities in the justice system.

"We know that the pathways of Aboriginal people with mental disabilities lead to contact with police, courts and custody — largely due to a lack of appropriate health, education, disability and community services," she said.

"Racism and stigma faced by Aboriginal people with disabilities drives the cycle of over-policing, under-servicing and incarceration."

Even with the over-representation of children in custody who have diagnosed or undiagnosed fetal alcohol spectrum disorders (FASD), Dr Gallagher noted: "It's important to note that people with disability in detention cannot access Commonwealth-funded programs such as Medicare [or] the Australian Government Hearing Services Program — even if they meet eligibility for such programs."

Mainstream Systems Failing Communities

Her comments came as the Disability Royal Commission's report, Options to improve service availability and accessibility for First Nations people with disability, found the "current state" of support had "failed to uphold First Nations rights and interests in operations and service provision" and was inconsistent with several principles in the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP).

The report found Indigenous NDIS participants are 28 per cent less likely to receive care via the scheme than non-Indigenous participants, and highlighted "unsafe, traumatising and inequitable services" received by First Nations people with disability. It also said Aboriginal Community-Controlled Organisations (ACCOs) and Aboriginal Community-Controlled Health Organisations (ACCHOs) "frequently deliver disability services with inadequate funding and resourcing".

Speaking on Friday, Dr Gallagher — Victoria's first Treaty Commissioner — said demand for First Nations disability support is set to rise sharply, with an additional 13,000 NDIS workers needed in the sector by 2031.

She argued the NDIS approach to disability is "standardised and overly focused on functional capacity," clashing with Aboriginal approaches that emphasise resilience, strengths and inclusion. Studies, she said, show Aboriginal people supported by ACCOs live longer because "culture acts as a key protective factor that enables people to feel included and supported".

"Did you know that in Aboriginal languages we don't even have a word for disability?" Dr Gallagher asked.

"That is because the treatment of disability in Aboriginal culture is more inclusive, whereas the Western approach to disability is to label people with what they cannot do. For Mob, our focus is on what we need to know about that person so we can ensure that they can participate in their Community to their full potential."

Call to Action

In finishing her address, Dr Gallagher stressed that if governments are serious about Closing the Gap, they must properly fund culturally safe disability services. She offered three practical steps for providers: build relationships with Aboriginal organisations to understand barriers; ensure recruitment practices are culturally safe; and support NDIS participants with Return to Country funding.

"It's not just a one-size-fits-all approach, but holistic and culturally grounded services. If we want better outcomes for Aboriginal people living with disability, then support must be delivered safely, respectfully and grounded in our culture," she said.

"If we are truly going to understand how to fix the structural problem of why Aboriginal and people with disability are not accessing the NDIS, then we need to understand the barriers that are preventing their access."