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Suicide in Australia

CHAIR (Senator Siewert) —Welcome. The Senate Standing Committee on Community Affairs is continuing its inquiry into suicide in Australia. Today the committee will be speaking to a number of organisations providing services in Western Australia, including many who have contributed to the development of the Western Australian Suicide Prevention Strategy. I understand that you have been given information on parliamentary privilege and the protection of witnesses and evidence.

Mr Somerville —I certainly have.

CHAIR —I invite you to make an opening statement and then we will ask you some full, searching and penetrating questions.

Mr Somerville —I am the CEO of the Aboriginal Health Council but I am also coming from the perspective of being the former Chief Executive Officer of the Aboriginal Legal Service around the time of the Royal Commission into Aboriginal Deaths in Custody. At that stage, I was also dealing with lots of families who were going through the trauma of suicide. I have also had experience as a community member of the Mental Health Review Board of Western Australia, which has now been absorbed into the Administrative Appeals Tribunal, but it is used to review the involuntary status of people in the community and in mental hospitals. That was an opportunity to reflect on and speak to people in the same area of mental illness who had been unwell emotionally and socially. Many of them were facing thoughts of suicide. I was also dealing with the families who were trying to cope with these things.

I would add that, when I first became involved with the board, I did not see many of my Aboriginal people in the institutions or even in community care. But, during the last part of my time, I was seeing increasing numbers of young people and young Aboriginal men linked with substance abuse, particularly illicit drugs.

I was also a community member of the parole board in Western Australia for about five years, until recently, again dealing with people in those situations.

Senator MOORE —Mr Somerville, with all that experience, what do you want to tell us about what you think should happen?

Mr Somerville —There are two things. We need an acceptance that support for these people is needed in the community and it needs to be integrated with their families. Many of these people appear to me to be very isolated from their communities and families, and the families are also already in difficulty and the mental illness becomes an added burden that they cannot cope with. When it leads to suicide there is this enormous sense of guilt: ‘What could I have done? What did I do wrong?’ I saw particularly when dealing with families during the royal commission that people go through shock, disbelief, blame and rage, and I saw a connection—many of the people who committed suicide during this period had close family who had done it before them. So the approach needs to be community based.

Secondly, we need to have a holistic approach. My experience is that services for people experiencing these problems are clinically and institutionally based, and I do not think they deal with people’s social and emotional wellbeing or, for Aboriginal people, their spirit and the generational issues that have come out of the stolen generation—not just for the people who were in institutions but for the second and the third generation, who are still connected to it. A problem with the institutional and the clinical based situation is that, once you leave Perth, the resources are almost nonexistent. I have had people explain to me quite simply that the only place that you can get quality services in a lot of these areas is in prison, because prisons have psychologists and assessments. Also, fortunately and unfortunately, when deaths in custody became an issue, people who were coming into custody were assessed for the risk of self-harm and suicide and they tried to deal with it. So the approach needs to be community based and holistic.

Senator MOORE —We have a copy of the fairly recent plan that has come out from the Western Australia government. Can you tell us what engagement your organisation has had and what you hope for the engagement of Aboriginal issues in this quite impressive-looking plan, in terms of the particular need for your community?

Mr Somerville —As I think was said before, we believe this is an Australian first in Aboriginal affairs because we had a real partnership between the Aboriginal community controlled sector, the state government, the Commonwealth government and the non-government sector, such as GP Network. We had regional planning forums with those partners. That forum drew up a plan which asked: what are our priorities in Aboriginal health? It then asked: what should be doing about those priorities, what is our action plan and who is best placed to do what? That meant that it became what I was speaking about earlier—community based, regionally based and holistic.

Out of the, I think it was, $117 million, $44 million was put to mental health and social and emotional wellbeing. As I understand, $22 million of that has been released to the regions for social and emotional wellbeing projects. The other $22 million was designated for a statewide approach. The difficulty we had earlier last year—before my time, so I am interpreting what people told me, but I am very confident about this—was that that was interpreted by the mental health division of the health department as needing to go to a new branch, a statewide Aboriginal mental health service. We said that that did not match what we had been doing everywhere else in Aboriginal health, and it certainly had not involved detailed planning with the regions. We said that we wanted them to find out what the priorities in Aboriginal mental health, were, what we needed to do and who would do what. About their service proposal, I said, ‘I don’t think we’re going to disagree about the range of services that might be available, but we do not accept that only a state public service agency could deliver it.’ We thought that, in terms of delivery, our community controlled services, linking with the social and emotional wellbeing money, would be in the best position to deliver and to coordinate.

Very recently, the mental health division was taken into the new Mental Health Commission. They now have responsibility for negotiating the $22 million that is still there. They have made it very clear that that commission will not be delivering direct services. At our statewide Aboriginal health conference last week, we met with the parliamentary secretary for mental health, the Hon. Helen Morton MLC. She made it very clear that they will not be directly providing services and that they will engage with us in a partnership back out in the regions.

CHAIR —So we are going back to community delivery.

Mr Somerville —Yes. We do not deny that at times acute care is necessary. Acute care might happen in hospital, in our clinics or with a GP, but we hope that will be decided at the local level. What has been released so far has our full support. There are some great projects in there, controlled by both the community and non-government and state bodies.

CHAIR —Sorry, I have interrupted you. I just wanted to find out where the other $22 million was. Of the $44 million, $22 million is going to social and emotional wellbeing—

Mr Somerville —Social and emotional wellbeing projects. The other $20 million is still sitting at the side until we decide how the statewide approach is going to take place.

Senator MOORE —What about the wider health strategy?

Mr Somerville —That is still under COAG. Mental health was one of the key strategic areas.

Senator MOORE —Within the mental health plan there is the suicide plan, which is $13 million over the next four years.

Mr Somerville —Yes.

Senator MOORE —I know that people have been involved at various levels. I am interested to know whether that engagement you have had with the wider mental health and wellbeing strategy, which you have outlined, is carried on into the specific suicide stuff.

Mr Somerville —No. I have only been doing this since 7 January. I have not had a chance to discuss that aspect because we have been so consumed with COAG.

Senator MOORE —It all links in together. There is no doubt about that. It would seem to me that, if not your organisation itself, at least your member organisations would be involved on the ground.

Mr Somerville —For sure.

Senator ADAMS —Thanks, Mr Somerville, for your introduction. Would you like to describe how your organisation did the work on the ground in Narrogin. You obviously have an ongoing commitment there. Could you tell us how you handled that.

Mr Somerville —Unfortunately, I was not the CEO back then. AHCWA took up a leadership role on behalf of the Aboriginal sector because there was no Aboriginal medical service based in Narrogin. I see Darryl is appearing before you later.

CHAIR —He is coming this afternoon, so we will ask him.

Mr Somerville —Darryl is my predecessor. He is strongly connected to the Narrogin community. If I could, I would like to defer to him. They now have formed the Nyungar Health Council, with the idea that it will be a regional body for Aboriginal health services. They have now taken leadership in Narrogin from us, but with our blessing. I can say that it was a devastating example of what a series of suicides can do to a small, closely related community. As I understand it, there is the big worry that it is spreading across the south-west now and that related communities like Albany are now experiencing it. I know that last year we were very keen that the specific cases be examined closely. Secondly, we were very concerned that there was support for the community, to provide some healing for them. We wanted to have some ongoing community based services there. I know that the South West Aboriginal Medical Service sought our support—which we provided—in opening an Aboriginal medical service sub-branch in Narrogin that will be able to extend the service. There is a huge population in the south-west. We have an Aboriginal health service in Bunbury and then we have an Aboriginal health service in the metropolitan area—Derby. But in between that it is very sparse.

CHAIR —I understand Paul Sheridan has left SWAMS. Are you aware of that? I only heard that at the end of last week. Is that true? Have you heard that?

Mr Somerville —Who was that again, sorry?

CHAIR —He is the person who was doing social work for at least the last 18 months—that I am aware of—for four days a week. He was working out of SWAMS but in Narrogin. I spoke to him a number of times and it seemed to me, from the outside, that he was doing a very good job. But I do not know if it is true that he has left. I have not had that confirmed.

Mr Somerville —I do not know. I do know that Darryl and Mick Gooda, the social justice commissioner, were down in Narrogin last Tuesday so Darryl would be right up to date with it.

CHAIR —Okay.

Senator ADAMS —I have a question on your conference last week, Mr Somerville. What were the main issues that came forward?

Mr Somerville —We talked about a lot of particular issues but the core thing was very much what I said earlier about being able to have community based programs resourced across the board in Aboriginal health and also the need to build strong Aboriginal health organisations and to provide some stability. That is what AHCWA’s role is. In the past people have talked about AHCWA as a statewide body concentrating on mental health, youth issues and those sorts of things. But they were saying they would like AHCWA to be able to provide the support and the expertise so that we can build strong, sustainable Aboriginal health organisations in very difficult areas. One of the things facing our health services is accommodation for staffing. Out of Closing the Gap we have probably got a new workforce of about 400 people. We do not have any fear about having Aboriginal people available to fill those positions but those that have to come in to new areas need accommodation. The threshold in terms of income and in terms of your government housing, your Homeswest housing, is, I think, about $30,000, so people who take up positions with us are going to lose their house. It is one of the things that Mick Gooda said he wanted to look at early in his time as social justice commissioner.

Senator ADAMS —So what recommendations, if any, have been made to government from the conference?

Mr Somerville —Yes, around those things, repeating the call that that other $22 million needs to be properly planned and properly engaged with the community. There was a recommendation welcoming the new mental health commission and our government’s focus and encouraging the continuation of this partnership. There was one other key recommendation which was saying that we were worried that in Closing the Gap we have got silos. We have got closing the gap around housing, closing the gap around health, closing the gap around education and we are saying we are whole people and we are just in different spaces at different times and it is all interrelated and we have evidence—I suppose it is community based evidence—and experiences from other Indigenous nations around the world. We have our young people under the age of 10 contemplating suicide. I had some discussions with the Blood Tribe health service in Alberta, Canada. They were saying that they had data saying that something like two-thirds of people under the age of 25 had seriously contemplated suicide, for the variety of reasons that we have been talking about. So we need to be aware of what is happening to all of our people in the different spaces. We have got people in prison. We have got people in hospital. We have got people in schools. If we do not connect the information together and if we do not integrate the resources that are going in, I think we will fail to a large extent, because of the way it interrelates.

Senator ADAMS —This committee has been doing an inquiry into hearing services and we have had quite a lot of evidence from different areas. People have been saying that with the justice system 90 per cent of incarcerated Aboriginal people have some sort of hearing loss. Have you been doing any work with hearing services and could you give us any evidence on that particular problem?

Mr Somerville —No. I have not done any direct work and I am not holding direct knowledge in my mind around it. I know we are aware. It goes back to that school thing. Things like otitis media are rampant throughout our community. Young children are getting it first. For environmental and ongoing reasons in terms of lack of treatment, it will continue and then that person is going into a new space. So their hearing problem would not have necessarily been fixed and unfortunately the space they are now in is a prison. I could get you some more specific information on what is happening in the hearing area from my organisation and our members.

Senator ADAMS —That would be very useful.

CHAIR —I am wondering if there are issues around linking hearing loss and the problems that that generates with mental health. Have you done any research or do you have any information around that space in particular? We did have some evidence on it. There was an example from South Australia of where somebody who had a history of rage and interaction with the criminal justice system, in particular over assault, had been in and out of the system. He was not a young many anymore, by the sound of it, but in prison they identified his hearing loss and they started addressing his hearing problem and apparently that really started addressing some of his issues as to rage, alienation and isolation. So I am wondering if there has been any work on the issues around hearing loss and mental health in the Aboriginal community.

Mr Somerville —Not that I am aware of. I will make inquiries back at my organisation and I will see. I am aware of a lot of discussion around the fact that behavioural problems in school are related to the same thing. It has also triggered a thought in my mind, and this is moving to another area. Recently we have been building strong links with the head injured area. I was actually speaking this morning with people from Headwest, which is the representative body here. We were talking about a similar thing, the frustration that people with head injuries experience which then leads to their ending up—as in many cases—in institutions. The people were talking to me about the despair. Often these people are coming from a very functional life and are going into a life where they are highly dependent. They are suicidal. Another discussion that we had at our statewide conference was about the effect of financial stress on people and about the enormous stress in the Aboriginal community over finances, leading to things like suicide.

Senator FURNER —Mr Somerville, I want to take you to some of the evidence we have heard through the inquiry on the reliability of statistics. You referred to some statistics from overseas about two-thirds of people contemplating suicide. How reliable do you think our data in this country is in terms of the gathering of statistics on the contemplation of suicide and also actual suicides?

Mr Somerville —I am not an expert, but I think the stuff that I hear seems to me to be very sensible and very reliable. I do not think it goes against what the community experience is. Our service has got a good store of data because we are usually the only service in town and we have a community approach. Our people are out there on the street and can see it. I would feel reasonably confident about it. I have not seen anything which is masking the problem. But I am also constantly saying that if we get enough by way of statistics to raise our concern then let’s move to action. I would certainly think there is an enormous store of data for the Aboriginal sector around the royal commission into Aboriginal deaths in custody.

Senator FURNER —Just concentrating on that particular area, the WA Suicide Prevention Strategy talks about the suicide rate of men in WA prisons being five times higher than that in the general population and then goes on to talk about the higher suicide rates for people on remand as opposed to sentenced prisoners. In your experience, how many Aboriginal prisoners on remand or who are sentenced would suicide?

Mr Somerville —In my experience, and that is going to the parole board, I think you will find that there is a much lower proportion of Aboriginal prisoners who are in fact on remand because of the nature of their offences, which are dealt with probably pretty quickly and then added to their criminal record, or the fact that they are breaching things like community service orders and parole orders. But I would say that, in sentenced prisoners, yes, that rate would be at least five times higher, if not more, because of the increased feelings of isolation and separation and the way the prison system operates. To give you an example, if you are sentenced for quite a serious offence and you are a Kimberley Aboriginal person, because there is currently no maximum or medium security prison in the Kimberley you will be moved to at least Roebourne and immediately be isolated from your family, who do not have the ability to visit you. But with the overcrowding you are probably more likely to be moved to a medium or maximum security prison in Perth, where the isolation becomes even more acute. The physical environment of prison is very confronting to Aboriginal people, who have come out of an open community and family situation. That is repeated in places like Goldfields, out into the Ngaanyatjarra lands, the Central Desert area. There are a very limited number of places for more serious offenders at Eastern Goldfields Regional Prison. Families just do not have the resources to come and sustain themselves in places like Perth.

Senator FURNER —So what is the length of remand in those circumstances?

Mr Somerville —I do not have the data to back it up but I would say—again, for a variety of reasons—that in my experience Aboriginal people would be more likely to plead guilty and want things dealt with. It is a very common thing to say, ‘I want to plead guilty or have my matters dealt with as quickly as possible.’ The vast majority of offences are in the Magistrates Court. We have also still got large numbers of our people going to prison for fine defaults or for breaching community service orders. We have got people in prison because they did not pay a fine for failing to vote or failing to return their registration papers for their plates.

Senator FURNER —Senator Adams referred to the hearing inquiry in the Territory; I think that is where we heard quite substantial information and evidence about what you were just implying. I imagine that lends itself to situations where people feel depressed and suicidal. Out of mere frustration or wanting to move on and get the matter cleared, in some circumstances up there they agree to the crime and to the incarceration because of a number of things, such as not understanding what the situation was and not being able to hear what the conviction was. Would that be consistent with your view?

Mr Somerville —And there is also this feeling of despair and ‘My life is just so out of order.’ I think some people think it is a bit of respite to get away from what is happening to them in the community or from the lack of things happening to them in the community. They think ‘At least I will be going somewhere to get away from it all.’ It is tragic but I think it is true.

Senator FURNER —But your point is the added frustration of not having communication with your family or friends and of being removed from those remote locations.

Mr Somerville —And that is why the generational suicide is such a worry. If you accept that for our extended family there is grief around not just the people who are suicidal but the many funerals you go to during the year and the many people you watch die in hospital, you can understand that you just get deathed out.

CHAIR —We received evidence in the Territory that a person could experience on average up to 12 traumas in a community—and the traumas were deaths in the community or of a close family member. I am pretty certain the number was 12. Has there been similar work done in Western Australia on the amount of trauma people experienced? We were talking about it in terms of what it does to people’s social and emotional wellbeing in having to cope with that sort of trauma and that level of trauma and also what it does to community. I am just wondering whether similar work has been done in WA. Given the size of our state, if work has been done, is the Kimberley different from the south-west and other places?

Mr Somerville —I do not know the answer to that. Again, I will see what our wider network of people who have been involved in this say. I do not know what sort of research has been done on the ridge, but I have had experience in all of the regions and the theme is very much the same. Some areas are even less resourced than others. I am not wanting to assume too much, but if you are in Broome you are going to be a lot better off than in country. If you are sitting over at Mt Newman, where my people come from, it is a different story. There is just nothing there for you and there is no awareness of the grief and trauma that is going on from not only suicide but death.

Senator FURNER —You spoke about the stresses in the Aboriginal communities. If you had to prioritise the types of stresses, where would you start and where would you end, ranging from things like substance abuse, employment, isolation, housing and those sorts of things?

Mr Somerville —I would say illness in all of its different ways and also worry, particularly about new drugs and their effect on the community, followed by accommodation and then poverty—just not being able to support yourself and your family. People who were on parole were coming to the program and saying: ‘I’m so worried about my family. Where is my family going to get its next feed from?’ That is the other stress on them: I was at Curtin University running a very good Australia-wide Aboriginal community management course. People would come from Queensland to do a two-week block of the course and they would say to you: ‘I’ve come here and my family has no money back home.’ I had one young man crying in my office because he had a new born baby and his wife had no money for baby formula. They were not spending their money anywhere else; I knew that. He said: ‘What can I do? I’m not going to be able to get home within 24 hours.’ I think the stress is that things are just so fragile for people. Somebody might be in a reasonably good job now, but they have nothing backing that up. There are enormous stresses on people.

Senator FURNER —How big is the substance abuse problem in the communities?

Mr Somerville —Talking state-wide, I would say that for our people who are under 40 years of age it is enormous; it is frightening, particularly in our communities within and around the mining sectors. We have had wonderful gains with employment and economic opportunities but the movement of large amounts of marijuana and amphetamines and the like is just destroying our communities. From my experience—more so from my time on the parole board because the ALS was a while ago—it was certainly affecting most of our people who were under 30. They are a big proportion of our prison population and their reason for being there was directly related to drugs. When it comes to the under 25s, drugs are a completely dominating factor. A part of the reason for that is these people are again separated from their community and living that other subculture. Their family is now the people who live in the same subculture as them. The stresses back on the family are just enormous. You get people saying to you: ‘I don’t know what to do. My son’ or ‘my daughter is just out of control and I can’t communicate with them.’ So they worry and they worry and they worry and then when people are in prison they worry even more. It is driving family violence. In those places where it is endemic, it is driving child sexual abuse. And it is moving at such a pace that it is just incredible. People say to me, ‘I’m going to leave my job here in Perth because I want to get out and take my kids back to community.’ But we know that in the central reserve—Warburton, the north-east goldfield—there has been a big influx of illicit drugs, particularly marijuana, across the South Australian border.

CHAIR —Is that the South Australian strip?

Mr Somerville —Yes, it is coming in there.

CHAIR —We have heard reports about a community—it is talked about all the time—and its name starts with an ‘M’.

Senator MOORE —The one that always misses out.

Mr Somerville —Yes. The other thing about marijuana and involvement in the mental health system is: I do not have the data in front of me, but people—for instance, the psychiatrist that I worked with on the board—are saying, ‘This is pushing your young, vulnerable men over the edge.’

CHAIR —It is a certain age group that it affects: older teens, and those up to 25; it is where their brain development is at, or something.

Mr Somerville —I have not seen him for many years or read his stuff for a number of years, but I did, back at the royal commission; have you run across any of the work of Dr Ernst Hunter?

Senator MOORE —Yes.

Mr Somerville —He talks a lot about these two high risk groups, in particular the postadolescent group, and he was drawing on some data about high proportions in the population and drawing in, I think, some South Pacific information.

Senator MOORE —And there is stronger marijuana; it is a different strength, from the different way of growing it. So the capacity of it is much stronger than it was—when I was young!

Mr Somerville —I know the hot spots. Broome is an enormous worry to us. And Broome was the hot spot for Ernst’s work; he drew that out. It has always had an enormous drug culture, particularly marijuana. You see a lot of young people—even though they are Broome people—get wrapped up in Broome as a tourist party town. So I am worried about the enormous use, right through the community there, of things like marijuana. But it is Kalgoorlie, Broome—these large centres of development. I know that the people who are distributing these drugs work on the vulnerable. Amongst our young people there is a market for them and they exploit it. We are working very hard on the ground in our organisations to raise awareness, but it is about getting to the belief amongst our young people that this stuff is not harmful.

CHAIR —We are just about out of time, and I know that you are on a tight time line. I just wanted to ask about the issues around Albany. Is it better to ask you or Darryl about that?

Mr Somerville —I think Darryl, because Darryl is very closely in touch with that.

CHAIR —There is a new organisation that Pat Dudgeon is heading up, the Australian Indigenous Psychologists Association. We heard from them when we were in Brisbane. They raised a range of issues, but one of them was the issue around—and I keep telling everyone that I hate the word—‘contagion’; that is what they were calling it. It sounds like, when a suicide occurs, the impact on the likelihood of copycat suicides is higher in Aboriginal communities. Have you found that that is the case as well in Western Australia?

Mr Somerville —Certainly. Again, going back to the Royal Commission into Aboriginal Deaths in Custody, I think they could show that, in every case of suicide, the person had had a previous direct relative—in what we call in the Western world their nuclear family—suicide, and often multiple. We have had dual suicides, too. We had one terrible one—I cannot remember the year; it may have been in the late eighties—where two young boys under the age of 12 suicided at Roebourne. And then in Port Hedland there were two older first cousins who suicided together.

CHAIR —I am not going to go to the issue of how many of the recommendations have been implemented or not because we would be here for quite a long time. But is the situation improving through the mechanisms that have been put in place? Overall, not just in custody but in community, are we seeing a reduction in the issues around copycat suicides? I do not like using the word ‘copycat’ either, but at least it is better than the word ‘contagion’. Are we seeing that reduction?

Mr Somerville —No, not yet. If these resources hit the ground at the community level, I think that people will be able to identify the risks and work with the people who are in this position, telling them, ‘You do not have to be an adult to be contemplating suicide,’ and working with the schools. As I said, it is about saying to them: ‘This is not your life. You do not have to have this life.’ This work is about the self-esteem of young people and getting them to recognise that there is a real future. I am in the situation now where I can say to a young person: ‘If you finish high school, I can guarantee you a job. I can—I can guarantee you a job. If you finish university, I can guarantee you the job of your choice.’ It is also about getting parents to carry the same message, that that future is there, and to have confidence in it.

If I could say one last thing as part of the issue of family support for young people, we have to find ways of bringing fathers back in: fathers of my generation who, for whatever reason, are missing in action—they are in prison, they are in hospital, they are dead. Children are really lacking having both their parents. Amongst my Aboriginal people, the role of uncles and fathers is so important to keep young people out of that risk group and to keep them spiritually strong.

CHAIR —Thank you very much. Your time is much appreciated. I feel we have just touched the surface of some of the issues, but it has been much appreciated. I think we could keep talking about this for a long time.

Mr Somerville —Thank you.

[1.47 pm]