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Community Affairs References Committee
05/07/2018
Accessibility and quality of mental health services in rural and remote Australia

NEWRY, Miss Nawoola Selina, Private capacity

[11:00]

CHAIR: Welcome, Miss Newry. I know you've given evidence before, because I was here a couple of weeks ago on a completely separate inquiry. Have you been given information on parliamentary privilege and the protection of witnesses and evidence?

Miss Newry : Yes.

CHAIR: I invite you to make an opening statement and then we'll ask you some questions.

Miss Newry : I'm appearing as a grassroots community member and a local Miriwoong woman. I was very happy to receive the invitation to come and speak on behalf of community this morning regarding accessibility and quality of mental health services in remote and regional areas. It's something that we have been discussing as a community for a very long time now. I really hope our voices get heard on this and we can see some change happen for the better of our community.

CHAIR: What's your opinion on the quality of the services?

Miss Newry : I've written up some notes that I'll go straight into. We do have a lack of services up here. If you ask a lot of community they'll say there are no mental health services. There are no after-hours mental health services in town, which makes it really difficult for community members. Clients are medicated over the weekend when they go into the hospital here for mental health. They are put on the ward with a security guard to watch over them. The security guard is not equipped for mental health situations. So that, right there, creates a bit of a gap. They are sent home to community. They are given video linkups, generally to Broome or Perth. That's just not good enough when we're dealing with people in community who are attempting suicide.

We have repeat suiciding in some of our families up here, which is just so traumatic for the immediate family, the extended family and the community as well. Because we have all this repeat suiciding and attempted suiciding in families, families are actually left out in community to deal with these situations as they arise. Family are unskilled. There are all different age groups of family there, from young children and teenagers to adults and middle-aged—everything. This also can create a bit of a monkey see, monkey do kind of situation. It's not really teaching people how to deal with their mental health and their emotional issues as they arise.

We have many family and community in town with undiagnosed mental health issues. I see lots of family that have undiagnosed depression, undiagnosed FASD and undiagnosed bipolar. Because so many community have these illnesses that are undiagnosed they turn to alcohol and drugs to mask their issues. When people are self-medicating on such a level in town it creates all these extra issues out in community. There can be violent outbursts and everything, which the family have to deal with, and then that can create further dysfunction in the family, trying to deal with that as well.

We had the big prison built over in Derby. I feel that's an absolute total waste of money. There should've been rehabilitation centres built in the Kimberley. There should've been healing centres built in the Kimberley if we really want to address people's trauma and help people through. Even the $45 million courthouse that was built in town here was a total waste of money. How is that helping people address their issues? It's not helping anybody address alcoholism, drug issues or mental health issues; all it's doing is creating further repeat offending and furthering the cycle.

We're really struggling in town to get any of these services on board to work with us as a community. We can't even get the services in town to go through cultural awareness training. I heard everything that Brenda said. She said some great things, and I totally understand where she's coming from in her role that she works from. But, from a community point of view, these people don't work with community. They come here and we have such a high turnover of staff up here, but it takes people at least two to three years to build relationships in town. They don't come to our community and do cultural awareness training. They sit in their offices from eight to four, they go home at four o'clock and they shut their door—their job is done. It's our community that is dealing with it. It's our community that is trying to stop our family from hanging themselves in the trees.

We've been working to really get cultural awareness training for all the services up here. I really feel the Public Sector Commission should be involved in this. The Public Sector Commission has been working with one of my friends down in Perth through Lifeline to prepare suicide training for communities. I spoke to him a few months ago and he said that he was getting the contract to deliver this through all government departments. I told him that it needs to hit the Kimberley first. It needs to hit the Kimberley, it needs to hit the Goldfields and it needs to hit the Pilbara first.

We need to be upskilling community. I also told him that he has the perfect audience through the Work for the Dole scheme. Everybody that's on Centrelink payments has to be engaged in this Work for the Dole scheme. Why can't we get all those people counselling services while they're engaging in Work for the Dole? A lot of the people that are involved in that Work for the Dole program are repeat offenders of alcohol abuse, domestic violence and all of these kinds of things. When we've got these people that have to engage in these programs, doesn't it make sense that we get holistic counselling and stuff to them? They could actually work in that room together with other people who have been through the same things and then go back into community and start to feel a bit better.

CHAIR: Peer to peer.

Miss Newry : Yes. I've been trying to get MG Corporation to listen and use this workers camp that we have just out of town. I've been saying to them for over a year now that we need to turn that into a multipurpose building for our community so that we could have healing programs and make it a holistic centre. We could help young people there, we could help women, we could help men—everything. It's just sitting out there doing nothing.

CHAIR: Is it empty at the moment?

Miss Newry : Yes. We need local training for our community. That's one thing that I totally agreed with Brenda on. But it's not good enough to just get people gammon bits of training. We need to actually really be upskilling community into degrees.

We need culturally appropriate psychologists on the ground here. It's all well and good for these people to come here with all of these degrees, but when they have no regard for culture they're not going to get anywhere. One issue I do have—I mentioned it last time, Rachel—is about the social media pages. Some of these people that sit in these services write really negative things about our community on their social media pages. How can those people then go and work with community and get the community to disclose such severe things like sexual abuse to them? When we can't even get these services on board to do cultural awareness training, what kind of commitment does that show the community? How much do they really want to work with us?

The government needs to tailor programs specifically to meet the community needs. The government needs to start listening to the people on the ground. We do have some good services here. Boab Health Services are a pretty good service, but there are not enough of them, and I don't think they have any Aboriginal staff. There should be 50D positions so you specifically have to be Aboriginal to apply to work in these services. The cultural awareness training should be mandatory for every staff member that comes to our community here.

There's no counselling follow-through. One situation: my sister lost her child several years ago now to leukaemia. She died three days before she turned 12. I was living in Perth at the time and supported her through respite care once she got out of Princess Margaret Hospital. My sister didn't know how to deal with anything that she was going through, and at the time her son was in juvenile detention. After little girl died, my sister has never had counselling. She's never had counselling. Her son is now a repeat offender in and out of jail, and my sister is a hardcore alcoholic. I honestly don't think I could say that I've seen a week sober since little girl died. So there need to be follow-through services, because then all that happens is we create this further generation of intergenerational trauma, and it's not good enough.

It's quite disturbing to hear that the families are not included in the case management plan. What Brenda said was something that was really disturbing to me, and I do see that in other situations, even though the hospital when I attend with my family to speak up for just a range of different things. The families are not included in the case management. I just don't even get how that can be. How can you expect to work with anyone and help them if you're not even talking to them, if you're not even asking them what they need or talking to them about how you're going to help them through this. It just does not make sense.

There need to be more school psychologists. There are not enough school psychologists. As far as I know, there's one for the East Kimberley.

CHAIR: For the whole of East Kimberley?

Miss Newry : I'm not certain if that's correct, but there has always been one—

CHAIR: We can try and find out.

Miss Newry : and there has always been over a six-month waiting list, and that's just not good enough. When we're talking about the levels of issues with our children and our community, why is the government not putting money into services on the ground like that?

I've been saying for a long time I've been trying to get our corporations to listen: we need a Koori court model up here. I could really see that being beneficial for our community. I've been telling people: if we had Koori court up here and our young people or community members went in front of a magistrate with elders and then they decided together on what the appropriate punishment should be from that, then we could actually link that into having holistic programs out on communities and out on country. We need to start looking at holistic approaches. We can't keep coming at community with clinical ways of dealing with things when we have we have to work holistically. We have to be bringing culture into the mix.

Our culture has been broken from the invasion and everything that has happened on this land. You need to remember Kununurra was only founded in the 1960s. It's very young, what has happened here. My family, my mother and everyone, tell me the stories of when they were hunted off land here, and there's still so much trauma from that, and that's just been handed down and handed down and handed down, and then people mask their feelings and their emotions and their trauma with alcohol.

Then we have the sobering-up shelter in town here, which does a good job, but it doesn't as well, because they get taken in there—the bus goes around at night, picks people up off the street, gives them a bed to stay in, gives them a shower, gives them a feed, and they're out by six o'clock in the morning. They have nowhere to go. There are no services there. I used to work at the sobering-up shelter. I used to say to them: 'We're not doing enough. We're just enabling this.' There should be services there working with the people who are coming through that door. We shouldn't just be putting people out on the street at 5.30 or six o'clock in the morning just for them to go and sit around out the front of Coles and then come back at five o'clock for a feed and another place to sleep. We don't even have homeless shelters here. There's nothing for youth or anything. I think we've gone so far away from community and what community really needs that we're just so lost now. But we need to bring it back to working with community, and a holistic approach.

CHAIR: Thank you. Senator O'Neill, I did ask a couple of questions earlier, so you can ask a question.

Senator O'NEILL: You go for it—I got a lot out of that.

CHAIR: So did I. We've heard all morning about the lack of rehab services. Why is the shelter just a sobering-up shelter, or in your understanding why are there no broader rehab services?

Miss Newry : I'm really not sure. I think that's just the funding stream that they've gone for.

CHAIR: That's what I was wondering. That's the funding they can access. There has not been funding for other rehab-type services.

Miss Newry : Yes. We've got the Wyndham dryout centre, which is really good. People can go over there as a family and stay there and get all this help and start to heal themselves. But when they come back here, and it's like the cycle starts again.

CHAIR: So people from Kununurra can access it. Is there a waiting list? Presumably people from Wyndham are also using the service.

Miss Newry : Yes. There is a waiting list. You have to be referred. They don't take self-referrals. I think a lot of it is through the court system. I have heard of other family members going to court, and instead of being sentenced they've gone to the dryout.

CHAIR: So that sort of model is available if you're referred through the court.

Miss Newry : Yes. We used to have a dryout centre up the coast. That was before I came home. Everybody said that was just amazing. It was a community-run centre out on country. That's where the prawn farm is being built now. It's out that way. I know that they're doing some structural things out there, but I don't think anything like that shelter. That was awesome. Our location as well makes it really difficult, because we're so close to the border and we have so many communities that way. That was really good for everybody to be able to access as well. Since I've been home for the last 20 years, everybody's been saying that was the best thing that this town had. We need more of them. One centre is not going to do it, when we look at the rates of dysfunction across the Kimberley.

CHAIR: At the risk of escalating the conversation, which I don't intend to, with the introduction of the white card, have you seen that help in relation to the services that were promised?

Miss Newry : No. All these wrap-around services that were promised have never hit the ground. If they are out there, no-one knows about them. These services that work here never come out into community. The only time you see them out in community is when they're driving around in their car and you know that they're looking someone for some situation. There is no engagement to build that relationship or that trust with community. It's still so segregated.

Senator O'NEILL: One of the things we've been talking about is building capacity from within communities. That's what you're talking about. But there's a big gap between where people's skill levels are and the big training challenges to try and get the proper training and partnerships. On Elcho, for the hearing, there were two ways—the best of whitefella medicine and the best of cultural knowledge and understanding and how we actually make those two things connect. That doesn't sound like it's happening. What are the big impediments? You talked about money being invested in the jail and the courthouse. I want to understand, firstly, those training challenges—what you see as solutions, how we could empower and identify talented people in community and quickly move them through processes to get formal qualifications and to have that celebrated in community. I also want, if I can, to get you to put something on the record about the interface between mental health and incarceration, for juvenile and adult justice.

Miss Newry : Before I go into that, I will add that there definitely needs to be mental health nurses in the emergency departments, as well. Sorry, can you start that again?

Senator O'NEILL: Training—identifying qualifications; and the juvenile justice, jails and mental health interconnection.

Miss Newry : We need to be supporting the grassroots organisations. I always say that. Our women's centre, Gawooleng Yawoodeng, do some amazing work in terms of assisting women escaping from domestic violence. We've been talking about how we can get psychologists through our centres. I feel that if there are psychiatrists and psychologists, they need to be coming through our grassroots services.

Senator O'NEILL: So they need to be in service, where the women are, rather than waiting for women to come to them?

Miss Newry : Yes.

Senator O'NEILL: And they need to be available after hours?

Miss Newry : Yes, definitely. We need 24-hour services up here, definitely. There's definitely a link between incarceration of young people and the lack of mental health services. Because there's so much trauma in most of our families up here, the parents don't know how to deal with that, and the parents are so traumatised themselves that the young people are seeing really bad behaviour, experiencing bad behaviour, experiencing their own trauma as well, which is leading them into all the crime, which is ending them up in jail. There needs to be further intervention before kids get sent away. We need to break that cycle of kids being incarcerated. If there are issues in the home, don't take the kids away from the family. Strengthen the family. Take the perpetrator out of the family. That's how we can start to rebuild our families.

Senator O'NEILL: Are the perpetrators the mothers or the fathers in most instances?

Miss Newry : It can be both.

Senator O'NEILL: Or a relative?

Miss Newry : It can be all of the above. It can be an extended family member. It can be the mother. It can be the father. But there is always some underlying mental health issue that has affected it.

Senator O'NEILL: So the perpetrators need support as well.

Miss Newry : Definitely.

Senator O'NEILL: Our last witness raised the fact that there is no rehabilitation for people convicted of sexual assault returning to community.

Miss Newry : There's not. It's naturally difficult. I'm not a rape apologist, and I don't want people like that near my community and near my young kids. But there definitely needs to be some services or something to help them. I think people also believe, 'They've gone to jail, they've done their time, they've learnt their lesson.' That's not the case. It's an illness. It's a sickness that that they need to address. We can't just keep putting this kind of people back into community. We need to protect our community. We need the government and the services on board, and they need to be working with our grassroots organisations.

Senator O'NEILL: I'll have to put more questions on notice. Are you a local woman?

Miss Newry : Yes, I am. I'm a local Miriuwung woman from garden area.

Senator O'NEILL: It's lovely to meet you, and I pay my respects. Thank you to your advocacy for your community. It is very powerful.

CHAIR: If you have any other thoughts, can you send them through?

Miss Newry : Yes.

CHAIR: Thank you very much for your evidence.