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Community Affairs References Committee
06/07/2018
Accessibility and quality of mental health services in rural and remote Australia

BARKER, Mr Wayne, Festival and Cultural Events Coordinator, Kimberley Aboriginal Law and Culture Centre

HAYWARD, Mr William, Social and Emotional Wellbeing Manager, Aboriginal Interpreting WA

LIGHTFOOT, Ms Deanne, Chief Executive Officer, Aboriginal Interpreting WA

O'MEARA, Ms Maureen, Chief Executive Officer, Aarnja Ltd

SIBOSADO, Mr Martin (Marty), Chairperson/WKEC Leader, Aarnja Ltd - Empowered Communities

Committee met at 15:03

Evidence from Mr Hayward and Ms Lightfoot was taken via teleconference—

CHAIR ( Senator Siewert ): I declare open this public hearing and welcome everyone here today. We acknowledge the traditional owners of the land on which we meet and pay our respects to elders past, present and future. This is the fifth public hearing of the committee's inquiry into the accessibility and quality of mental health services in rural and remote Australia. I thank everybody who has made a submission and appeared before the committee up to now, and those who are participating today.

This is a public hearing, and a Hansard transcript of the proceedings is being made and the audio is being broadcast via the internet. Before the committee starts taking evidence, I remind all present today that, in giving evidence to a committee, witnesses are protected by parliamentary privilege. It is unlawful for anyone to threaten or disadvantage a witness on account of evidence given to a committee, and such action may be treated as a contempt by the Senate. It is also a contempt to give false or misleading evidence. The committee prefers all evidence to be heard in public, but, under the Senate's resolutions, witnesses have the right to request to be heard in private session—we call that in camera. If witnesses would like to be heard to private session, could they please let the secretariat know as soon as possible, because there's a process we have to go through to make that happen.

I now welcome representatives from the Kimberley Aboriginal Law and Culture Centre, Aarnja Ltd and, via teleconference, Aboriginal Interpreting WA. Thank you for coming. Could I double-check that you've all been given information on parliamentary privilege and the protection of witnesses and evidence?

Mr Sibosado : Yes.

Mr Barker : Yes.

Ms O'Meara : Yes.

Ms Lightfoot : Yes.

Mr Hayward : Yes.

CHAIR: Thank you. Do you have any comments to make on the capacity in which you appear?

Mr Hayward : I'm also a representative for WA Family Matters.

CHAIR: Could I invite each of your organisations to make an opening statement, if you want to, and then we'll ask you some questions. Mr Barker, do you want to start?

Mr Barker : Thank you very much. KALACC welcomes, and thanks the committee for, the opportunity to present its submission to this inquiry. In relation to the terms of reference, KALACC has little or no interest in the following terms: the nature and underlying causes of rural and remote Australians accessing mental health services at a much lower rate; the nature of the mental health workforce; the challenges of delivering mental health services in the regions; attitudes towards mental health services; and opportunities that technology presents in improved service delivery.

We emailed the committee on 5 April expressing concern, indeed alarm, at the scope of the terms of reference and associated media reporting. Our alarm is based on the highly credible view that Aboriginal suicide in the Kimberley has very little to do with clinical mental health. Indeed, the government's continued focus on clinical mental health is in itself one of the greatest impediments, if not the biggest, to effective responses to the chronic crisis of Aboriginal suicide in the Kimberley. In that correspondence of 5 April, we attached for your information a copy of KALACC's 3 August 2017 submission to the WA coroner, Ros Fogliani. The title of that submission to the coroner is 'Still more counsellors?' This is a phrase coined by world renowned expert in Indigenous suicide Professor Michael J Chandler. Chandler writes:

… if suicide prevention is our serious goal, then the evidence in hand recommends investing new moneys, not in the hiring of still more counsellors, but in organized efforts to preserve Indigenous languages, to promote the resurgence of ritual and cultural practices, and to facilitate communities in recouping some measure of community control over their own lives.

KALACC has considerable interest in the following term of reference: the higher rate of suicide in rural and remote Australia. This is our core base. We take the opportunity now to summarise the views which we presented to the WA coroner last year and, also, to make reference to the Commonwealth government's key planning processes regarding Aboriginal wellbeing: Closing the Gap Refresh—this is in our submission—and My Life My Lead.

Those are my opening comments to set the framework and for why I'm here today. We have tabled to the inquiry our document, which I will leave here for the record, and I would like to refer you to the summary of the feedback from Western Australia's closing the gap consultation. As part of the Closing the Gap Refresh, the Western Australian government, led by the Department of Premier and Cabinet, has undertaken a state-specific engagement process, which has consisted, broadly, of community workshops, a technical submission process and a review of relevant literature. Throughout the consultation it was constantly stated that (1) we need a fundamental and transformational shift in the relationship between government and Aboriginal Western Australians; (2) we want advice that disrupts business-as-usual approaches and sets a new shared direction that enables real change on the ground; (3) we must work together and enable Aboriginal and government commitment to a strength based approach of a co-design in a place based way; (4) we must co-identify priorities that inform how we work together to design and deliver programs and services for Aboriginal people; and (5) Aboriginal organisations are the local solutions and need recognition as valued long-term never-give-up culturally strong service providers.

On the community consultation findings, the WA Department of the Premier and Cabinet has taken a place based approach to consultations and, since November 2017, has facilitated workshops in more than 10 locations—Kimberley, Mid West and metropolitan—engaging over 180 people. Workshops were hosted, where possible, by local Aboriginal-community-controlled organisations, principally using the method of co-design to ensure the Aboriginal voice in Western Australia was adequately captured as part of the Closing the Gap Refresh. I will give the key themes identified through these consultations later, and I'll leave this document for you. A summary of potential targets and indicators raised at the workshop is in the attachment.

Three main themes have emerged from the community consultation to date. The first is Aboriginal self-determination and the need for Aboriginal nation building. Possible priorities to achieve this include (1) the recognition of intergenerational trauma and the need to redress systemic racism; (2) the need for holistic healing and family reunifications, to address children in care particularly; (3) the formation of and support for regional Aboriginal governance and engagement structures to government and industry; (4) accelerated economic development including increased use of Aboriginal organisations and Aboriginal businesses in government goods and services delivery.

The second theme is the presentation and promotion of Aboriginal culture through elder inclusion, including early years investment with place based family support services with childcare and parenting programs and youth hubs to support child development through key milestones, and for community engagement in youth diversion from the justice system. Just on that point, I'll deviate from my speech. KALACC, as a cultural organisation, has been working diligently for the last 20 years, particularly surrounding our Yiriman Project, in trying to address real, on-the-ground place based activities within our capacity. That capacity is as a culturally based organisation with a handful of committed men and women, both elders and others, trying to find a solution for these young people. It's not a solution for all, but it is a solution for some. Our objective is not to be a law enforcement agency, because there are agencies for that, but it's to try and find a way in which we can relieve the trauma and the stress within these young people, which will give them a chance for a breath before they re-engage back into the community, which they find traumatising in itself.

We are currently talking with the superintendent of police, Allan Adams, about ways in which we might be able to work together. The conversations, which have happened at high levels, try to paint a picture of where we as individuals can try and make a difference. The frustration we feel is that we don't see any traction from government or an indication that the government has an interest in what we do. We talk about Michael Chandler's reaction in terms of less counsellors. His term is 'fishing in the wrong pond'. It has clearly been articulated in the Kimberley Suicide Prevention Working Group, which has now been in existence for over 18 months or so. The discussion and the talk has always been the same. You could almost carbon copy the discussion and the minutes for the first meeting and reproduce it for the fifth meeting. The frustration we as a cultural organisation feel is that there is no enactment of the discussion. While there is a lot of passion around the table, there is certainly no commitment to making anything move other than that held within a few individuals who have a personal stake in this space. You know some of those individuals.

I return to the statement. Participants expressed that this is the first time government has come with an empty page. This is in recognition of the state governments really starting to think, 'We haven't been able to achieve much in the past; what about we start with a clean slate?' There are people in this room who are part of that process and need to be acknowledged in that space for making the shift towards at least understanding or having the opportunity to hear what we have to say about this.

We are eager to identify the priorities that have mutual benefit for Aboriginal people and government such as relationship reform, a willingness to transform the relationship between government and Aboriginal communities into one that is premised on shared planning, co-design and early intervention. I will step off the script for a moment. One of the discussions we are having with Alan Adams is how we do that. How do we practically identify the individuals and groups that are of interest for the department—in this case it's police—and how are we as cultural organisations to jointly form an interventional process that relieve the pressure on Alan to produce some real dividends in terms of crime reduction to our focus, which of course is the safety and preservation of these young people so we don't find them incarcerated. This discussion is happening independently of everybody else, and this again is the frustration we feel as a cultural organisation. It takes individuals outside of the process to try to create real change for government to stand and take the applause over. It's not the government that's doing it; it's the individuals at the coalface that are doing it. This has been the case for many years across many industries.

I will leave it there because I think there are others around this table who would be able to articulate that, but I must commend the state government for, in particular, the consultation process and the willingness to talk to Aboriginal people, with the view that there is an appetite for co-design and shared responsibility in terms of intervention.

CHAIR: Thank you.

Mr Sibosado : I'll give Empowered Communities' view, which doesn't differ too much from the opening remarks around whether it's mental health inquiries or closing the gap. You name it; there are any number. There are the national suicide trials, in particular in the Kimberley. They're all one and the same. And so as an organisation, we and our members agree with The 2017 national report on mental health and suicide prevention, which was auspiced by the National Mental Health Commission. The National Mental Health Commission says:

In order to create change and improve the life expectancy of people living with both mental illness and physical health conditions, there needs to be significant cultural change, community buy-in, and shared ownership and responsibility for action.

As the Kimberley Aboriginal Law and Cultural Centre says, increasingly there has become an awareness in the Kimberley amongst Aboriginal organisations and service providers. It's about the system and how it gets delivered: the silos. The health department doesn't talk to the housing department. As we speak today, the National Partnership Agreement on Remote Indigenous Housing has up to 10,000 Aboriginal people, the majority being in the Kimberley, sitting in limbo. That causes stress and trauma. The National Mental Health Commission report identifies all these factors. If you pick up another document, called Closing the gap, or want to pick up any other document looking into Indigenous disadvantage and dysfunction, the message is the same except there is no traction. Yes, there is lots of goodwill; nothing is done with bad intent. But the reality is that it's those institutions of power—government—that create legislation.

The factors that cause mental health are known and, as we say, surely, when you look at all the closing-the-gap indicators that we collectively strive to close—as a colleague of mine says, Aboriginal people are not predisposed; it's not in our genetics or DNA to be criminals, yet we make up the highest rate of people incarcerated. The abject poverty of our remote communities and some of the issues getting to the inquiry's terms of reference about remoteness and locality, and so I don't want to criticise unnecessarily service providers. That's a fact of life in a vast geographical area like the Kimberley. But the biggest obstacles to addressing mental health issues or closing the gap—I say they're one and the same, because the terminology around intergenerational trauma is misunderstood. Yes, it's a sort of recent phrase and a recent finding in terms of closing the gap and all the various dysfunctions. There is also all the medical and scientific research into mental illness and mental incapacity in an individual. Illness doesn't see colour. We're all the same; we're human beings. We operate the same way.

I would estimate—and I am not a medical professional or anything like that—that the research suggests that, when you look at the causes of trauma or whatever words you want to use that create mental conditions, quite clearly we have any number of traumatic events from childbirth, which then, according to the medical profession and data, impact on things right down to life expectancy of individuals and risk-taking behaviour. All of those things can be attributed to our people and our communities. The dispossession and other traumatic events in our lives are now established, and I think medical and scientific research into the causes and effects quite clearly show that Aboriginal people sit at the top of that tree. It's the wrong prize to sit at.

Despite all the resources and efforts of government and well-meaning organisations and Aboriginal corporations, the thing we haven't got right is how we collectively address these issues. We're used to working in an old service delivery system I don't need to say that millions of words have been written about the lack of coordination, the siloing and the lack of a strategic, sustainable plan going forward. Basically, every issue affects remote Kimberley people, and I'd say the minority of non-Indigenous people on pastoral properties that live remotely experience the same sort of issues that the majority of remote-living Aboriginal people would experience.

I'll leave it at that as an opening remark.

CHAIR: Thank you. Ms O'Meara, did you want to add anything?

Ms O'Meara : I would only say that, when we talk about intergenerational trauma, we also consider the fact that it's passed down through generations. We weren't involved in the massacres necessarily, but those traumatic events also live with us from birth, as does being removed from land. The policy settings aren't necessarily right for Aboriginal people now, with institutionalised racism and social inequality still products of the system that we're in.

So when you look at, for example, some of our decision-making in the Kimberley—no disrespect to the organisations or departments here—when we sit in discussions on Aboriginal people, it's predominantly non-Aboriginal managers who sit in that space. They're getting direction and some information from their Aboriginal staff, but the Aboriginal staff aren't at that decision-making table. That needs to be changed if we're going to get any traction within the current system.

Ms Lightfoot : Ngaji gurrjin—hello, how are you all. I'd like to acknowledge and pay my respects to the Yaruwu traditional owners past and present for the grounds on which the committee and everyone else is sitting today and also to Noongar traditional owners past and present for where we sit today. I apologise for not being with you in person. We'd like to thank you for the opportunity to share our work, our vision and our actions for our people. Can I say on behalf of the board that addressing mental health, intergenerational trauma and vicarious trauma will not happen for remote and rural Australians, wherever they may be, if it's continually attempted in high English without regard for traditional Aboriginal languages.

We're AIWA, or Aboriginal Interpreting WA, previously known as KIS, or Kimberley Interpreting Service. We're a self-determined Aboriginal organisation with a board of directors representing the cultural diversity and geographical range of our state. We're an initiative of the Miriwoong people in Kununurra and have been in operation for the past two decades. We work in over 40 WA Aboriginal languages throughout the state and deliver services mainly onsite but also via phone and video-Skype, and currently we're exploring avenues through telehealth. We're committed to bringing two-way understanding to interactions between WA Aboriginal language speakers and those responsible for delivering services of any kind across all fields. This is achieved through advocacy, development of policy and procedures, interpreting and translating, and three-pronged training, which is for interpreters, those who work with interpreters and community members on their right to engage interpreters.

I'd like to raise the issue of equal access to mental health services for clients who do not have English as a first language. William will follow me and will speak to the value of establishing supportive workplace practices within our own organisation, specifically our social emotional wellbeing framework built by co-design with our board of directors to ensure culturally appropriate ways of addressing and eliminating vicarious trauma, which is common within the profession of interpreting if it's left unaddressed.

English is not the first language for many Aboriginal people in WA, and many are missing out on equal access to services because of that. As we know, it's a basic human right to understand and be understood in your first language. That's stated in article 13 of the United Nations Declaration on the Rights of Indigenous Peoples. It says government shall 'ensure that indigenous peoples can understand and be understood' through interpreters. We also have underpinning policies in WA: the Language Services Policy 2014 and, specifically, the Public Health System Language Services Policy 2017, which states that everyone who does not have English as a first language is entitled to have an interpreter and that all government employees be able to ascertain when, why and how to engage interpreters. The policy also states that health professionals, including mental health, have a right to be able to communicate effectively with their patients, that patients have a right to equitable access to health services, including mental health, and that mental health professionals have an obligation to draw on interpreter services to achieve equitable access for their clients.

Unfortunately our stats reflect a great lack of engagement of interpreters for mental health services in WA—there have been 11 engagements since 2016. That's for a variety of reasons but it inhibits the culturally and linguistically appropriate safe and clear ways of rights also required under the Mental Health Act. We've identified the barriers as being the awareness of the right to engage an interpreter. There's also a great misconception that people are speaking standard Australian English when in fact many Aboriginal people are speaking Aboriginal English or Creole, which are, in fact, different languages, where English words are being used but with completely different meanings and concepts. There is one word that is a trigger in the mental health system and that's the word 'finish', which can be understood as the word 'die'. It can be quite dire when patients hear the word 'finish' in conjunction with the word 'medicine'. Also gratuitous concurrence is often presumed as a yes and familiarity is often confused as understanding. Many people report on budgetary constraints.

There are also great benefits for engaging interpreters within the policy outlined. More recently, the Western Australia Country Health Service began a six-month trial that includes having a standby interpreter five days a week in Broome at the Kimberley Mental Health and Drug Service, which is a great start. They've recognised the benefits for consumers, for staff and for the system as a whole. We request that engagement of interpreters is standardised and valued as a supplementary service to mental health services for rural and remote Australians and also for those people in the metro area

Mr Hayward : I will speak to the trauma informed practice of the AIWAR interpreting and the wellbeing of the interpreters. The core aim of AIWAR social and emotional wellbeing framework is to create a comprehensive culture of trauma-sensitive resilience. It applies to the nature of the trauma that's caused. Trauma is not a weakness or a deficiency of our service; rather, it is a practice consideration to respond to within our workplace culture. AIWAR's practice approach is to create culture of self-reflective practice, utilising supervision frameworks which deliver individual and group debriefing, group training and continuous professional development. AIWAR's governance, leadership and service delivery layers are highly responsive to their own practices—the responsibility to nurture and grow the culture of trauma-informed sensitive resilience. What is different about our people is it's a shared and lived experience. Our communities have interpreters from Indigenous languages who are accredited and qualified, covering 40 Indigenous languages and registered to work at the highest levels. We are members of WAITI, the Western Australian Institute of Interpreters and Translators Inc.

The experience and the impact of interpreting is as different as living is for everyone. It is normal for interpreters to have reactions during interpreting the stories of others. It's commonly accepted that all interpreters experience and feel symptoms of vicarious trauma and compassion fatigue. Interpreters are placed in a unique position as a conduit of verbal communication. This often means a heightened observing of another person's trauma. The fact is that interpreters tell services that this trauma is part of our interpreting. The observing of another person's trauma can transform your own inner sense of identity. It impacts you physically, psychologically, emotionally, spiritually and culturally and every aspect of your holistic being may be impacted and altered by the transfer of another's trauma. This is a normal response, and it is okay. However, it must take time to self-care as a workplace, as a team, as individuals. So the trauma that people feel—it may be short term, it may be long term—it affects, but it persists after interpreting has finished. You may feel heavy, you may feel like work has got inside of you, but the impacts of vicarious trauma on interpreters is similar to post-stress disorder. People have intrusive thoughts, dreams, nightmares, flashbacks, images, psychological reactions, heart pounding, dry mouth, nausea, shaking. They have voidance reactions, where people withdraw from work and engage in activities relating to traumatic material. Hypervigilance, restlessness, agitation, difficulty in concentrating. Emotional shutdown, extreme fatigue and disassociation.

What is important is that we create a group and individual debriefing framework, where people were prepared for their jobs, debriefed after it, creating a framework of self-care, that is respect for ourselves and our understanding that it's right to feel comfortable, safe, accepting and nurturing, and your own personal responsibility to care and look after yourself.

Often while servicing the community self-care can become distant thoughts or priorities. Self-care is achievable and it is important to understand that it's a simple, step-by-step daily approach. It starts with comprehensive self-awareness of professional and personal challenges which impact your wellbeing in both physical, emotional, mental, spiritual and cultural frameworks. In the context of interpreting, self-care helps us to manage the levels of vicarious trauma which is acceptable as a norm within our field and role. It is an effective strategy to prepare for interpreting and maintaining strength to ensure your longevity in the interpreting field. This wellbeing approach is a direct and effective way to respond to the impact of emotionally overwhelming stories which we channel in interpreting for our communities.

CHAIR: Mr Hayward, I'm wondering how much more you have in your opening statement. I have some senators here who are really keen to ask some questions.

Mr Hayward : We can provide this later.

CHAIR: That would be fantastic, if you could. I think you have some really useful information that it would be great to have, but I am also aware of our time constraints.

Mr Hayward : I understand that. I'd like to make just one more point. It's important that we look after our own workforce because the most important thing is that people are put in the most challenging situations, and people don't understand the cultural and spiritual implications of what is normal for other people and the impacts of our kinship systems and our relationships, not only to ourselves but the reciprocal obligations to others. So as an interpreter, when you're faced with that, you not only take on the job, you take on the energy and the feeling and the impact of your own whole community.

CHAIR: Mr Hayward, you've argued that really, really eloquently, and you make some really important and strong points that no-one has made to this committee in such an eloquent fashion. Thank you very much. That's a really important point. I want to start by asking Mr Barker some questions. I do have some questions for you, Mr Hayward and Ms Lightfoot, in a moment. Mr Barker, can I get straight to the points that you were making and have now been implemented. I've spoken at length with KALACC about these issues in the past, and I've also had lots of correspondence. I understand points that you're making, and I'm sure my colleagues do too. I've also read quite a bit of Mr Chandler's work and attended lectures that he has given.

Let's get straight to it in terms of the trials and what's happening now and whether you're satisfied. The essence of your arguments in terms of the importance of culture and making sure people are strong in culture and how that then impacts on their wellbeing, in your opinion is that being addressed in the approach that's been taken with this trial and the way the strategy has been developed?

Mr Barker : No. We are totally dissatisfied with the process. We entered into the arrangement with eyes wide open but somewhat clouded with rose-coloured glasses, assuming that this time we may be able to set up some partnership arrangements where we could trial some innovative, out-of-the-box solutions to try and have an impact on the monumental issue facing us, which is suicide and self-harm that permeates this region, let alone the stats that are shown nationally. We're continually frustrated. The mountains of documents that we as an organisation have produced with our partners and others have gone nowhere to satisfy us that there is a willingness or even a comprehension of what it's going to take to make a real difference on the ground. We're not even talking nationally. We're talking regionally. We are trying to propose to the committee just an idea of doing a trial. The problem is, as Marty says, you have silo arrangement here. This is an inbuilt system of service delivery that will never be broken, simply because everyone is looking after their own patch. The billions of dollars spent on Aboriginal services are certainly not hitting the ground in real terms, from a cultural perspective. If all the evidence before us states that culture is the cornerstone of some real change, which is empowerment, which is what Maureen is talking about in terms of community empowerment, if the change is with us then surely there must be a chance, or at least an indication, that if government hasn't been able to achieve it to date, why not give the blackfellas a go? Maybe we might be able to make a difference. We don't need a lot of money. We just need the go-ahead to get the key organisations and the key people around the town and say, 'Let's work out a plan.' We don't see a plan. We see self-righteous—sorry I have to back off a bit. I'm very passionate about this. I am frustrated to see, time and time again, the conversation is almost duplicated. Every conversation we have seems to be just regurgitated, but at the same time we are seeing the numbers in our jails and cemeteries and the pain and anguish on the faces of our families. It's unacceptable in any society. It is unacceptable now, it has been in the past and it would be unacceptable in the future. What I am looking forward to from a government is to see on their watch what they haven't been able to achieve. That's what I seek. Excuse me for my bluntness. I am frustrated, because I have to go now and look into the eyes of old people—yesterday there was another person—and we have to participate, once again, in creating a situation of consoling their pain and hearing them say, 'You're a cultural organisation—what are you doing to make government listen to us?'

You hear about the trauma of interpreters. Interpreters have many forms. What William was talking about is absolutely right. Cultural organisations like ourselves get it from both ends. There is great expectation, but at the same time we're at the coalface because of our passion. We're not there because government has provided the money for us to go off and do that. If you look at the salaries of Indigenous organisations compared to public service, you will see that there is a great divide between what has been delivered and what is being actually achieved on the ground. Excuse me for my bluntness again, but if Aboriginal organisations were empowered financially to start to deliver, even in the short term, on a trial basis, and ask those that hold in the silos intact for their own preservation to let it down and break it down and create a model of a trial. That's why we entered into the Kimberley suicide prevention trial. We have seen no movement in that. I don't see that there will be a movement in that. So KALACC as a cultural organisation says, 'What's the point?' We might as well spend the limited amount of hours that we do have on the day chair going off to the next mother or grandfather or father who has just lost another child in the space.

CHAIR: Thank you, and please don't apologise for your bluntness. That's what we need.

Mr Sibosado : Could I add to that, because I also sit on the Kimberley suicide trial project. I will go further. It's been 12 months. We are supposed to be the community reference group. The steering committee, whether she's the program manager or some manager in the Department of Health, and equally in WA Health and the Kimberley Aboriginal Medical Services they're the actual steering committee, along with the minister, Ken Wyatt. All we get, as the community reference panel—they said, 'We'll set the strategic plan and we'll bring it back to you.' What did we get? Two meetings in 12 months. No action. At the last meeting they came back and said, 'We'll just give the money out.' As community organisation we thought we were going to be consulted and involved in the establishment of the trial. It's just gone to a fixed interest group. I will be blunt about it, because that's what it is. Why am I passionate about it? As Mr Barker said, there's a funeral tomorrow up at One Arm Point. It's one of my countrymen, a 17-year-old. I got involved in that, emailing them and saying, 'Please, professional people, WA Health, can you send a counsellor? The community have rallied, they've got around the young friends, they've organised barbecues. They're doing the best they can but they're not counsellors.' The response I got was, 'Marty, we had an emergency crisis meeting in town yesterday.' I said, 'What good is it in town? The need is out in the community. That person is young, he has young friends, he has young siblings. They need counselling.' In regard to your question about the Kimberley suicide trial, I can say to you up-front that it's a sham. The fact is that us community reps have sat there for 12 months, haven't been consulted, have had no input, and any time we try to say anything we get bullied by the Minister for Health, who chairs the meeting, to shut us down because I'm talking against his industry.

Senator O'NEILL: My questions were about how the suicide prevention trial is going. I think you answered that pretty quickly. There is so much hope that's built from so many stakeholders of what this might offer in terms of a new way of exactly the kind that you've articulated, Mr Barker. Hearing your evidence today is really distressing. I think it was in October last year that I was here, trying to keep a handle on what's going on. We have more evidence to take today and we'll hear more from others about what they think is happening. Can I go to your comments about the need for a cultural solution and ask what types of culturally-based programs, which I'm sure you've been advocating for, should be funded to reduce the mental health needs of the first nations communities?

What does it look like when you tell us this is what we need? It doesn't look like what we've got, so what does it look like? If you can help get that on the record, that would be really helpful, Mr Sibosado.

Mr Sibosado : Mr Barker and I are colleagues and sister organisations.

Senator O'NEILL: You can talk over one another as much as you like, then!

Mr Sibosado : What does it look like? We've actually developed and we're rolling out on the peninsula. We started that Ardyaloon, One Arm Point, which is Bardi and Jawi people. The way we're designing is in terms of a family empowerment project. Why? It's on a cultural framework; it can't be done by service providers or government. Why? Because, as I say, it's based on Bardi and Jawi cultural frameworks—it's about families. We've got community navigators on board from the community to go around and map the families—not the nuclear families but the extended family groups—hopefully with some support.

What we're trying to do in terms of service provision—when you talk about closing the gap, who creates the statistics? It's individuals, not corporations. In remote areas what tends to happen with service providers—and I'm guilty of that at different times; if I want an answer I pull up at the community office. The person there full time, the majority of the time, is the CEO. I could be generalising, but in my experience the majority are non-Indigenous CEOs who have a shelf life or a job tenure of about three to five years, if they last that long, in our remote communities. With service providers, as I said earlier, it's about the distance and remoteness and wanting to get some answers. Generally we tend to pull up at the community office. The only person in there is the CEO, who is generally non-Indigenous. We ask some questions and we frame our whole response on what that person tells us for that community, and then we'd try and close the gap. The indicators or the statistics of closing the gap are created by individuals, not by communities, organisations and entities. It's the individuals.

We chose the family empowerment approach to try and set up a structure where you could go to families. We have natural carers in our families; not the whole family dysfunction—you've heard of nannies looking after children and all the rest of it, and that still occurs. So what we're trying to do is to use that cultural framework around families to plug in the service providers through the families. That way we can know that the services and the outcomes we all seek around closing the gap reach the ground to the people that make those statistics. We can keep investing in organisations and entities; we aren't going to cut it because at the end the day we need to get down. You can plug in men's groups, women's groups, health, education, et cetera. That's the way the Aboriginal culture works; it's generally families looking after each other. So we're attempting that.

It's very early days. We've mapped the families and we're developing a template that we're hoping to take across to Kimberley. We'll flesh that out. When we talk about changing the way we deliver services, government equally needs to partner with us because government has the resources to trial these sort of things.

Senator O'NEILL: Have you got any money from a suicide prevention trial to do the work that you've just been describing?

Mr Sibosado : No. I just want to relate that Maureen and I have spent this week in Fitzroy Crossing and Derby. Coincidentally, one of the groups we visited yesterday was the Derby suicide local action group.

Senator O'NEILL: We met with them this morning.

Mr Sibosado : In December last year—I just want to make the point—we were told quite clearly by the Kimberley suicide steering committee that they'd met with them and that they would fund them. Lo and behold, at the last meeting I see in the minutes, 'Sorry, your project didn't meet the program guidelines.' So they had words to say to me yesterday, and I said, 'Well, look, I don't make decisions; I sit on the committee, and in fact we're powerless.' But that decision was made by fairly senior people in front of the whole committee that we would fund that Derby local suicide project. They're just disappointed, you know. So, when local communities attempt to participate and come up with solutions and actually be involved in it, that's the sort of response they get.

Senator O'NEILL: Just for the record, Mr Sibosado, there's been no funding for the project that you were just describing. You talked about people who were going and basically surveying their community. Are they paid for that cultural work in any way?

Mr Sibosado : Ours are, through a partnership with a service provider. We use local people. The elders are involved in that community, so it has the whole range of it. That's all we're asking to trial, and I think KALACC would be along the same lines, even down to the governance structures of that community, because the reality is that one of the things we discovered in that project was from the old people, who said: 'We used to operate like that until funding came, and the Westminster system, and suddenly we were in corporations. If we had our way, we would deal in families.' I recall that as a young man that was my first job up at that community, and the housing clusters were set up around families, around where people were housed. It was set up around families. So the old people said, 'Look, that's the way we used to operate until government funding came, and then it became corporations and entities under corporations law, and that's killed all that.' Mr Barker, you might want to comment.

Mr Barker : Thank you, Mr Sibosado. Can I just give you a snapshot of the situation in these townships and communities. We all know that these communities and townships are under stress, and there's trauma, and there are multiple actions against strong wellbeing and happiness for young people. Right at the coalface there are these houses and these homes run by old women who are on the pension, who probably lost their husband years ago through alcohol or drugs or being run over by a cattle truck. These safe houses, which they run and organise and where they've given their heart and their soul to the preservation of their children, are really where the duty of care, in my view, shines. When you look at how they are resourced, they resource themselves out of their pension cheque. They're the ones when the children at three o'clock in the morning find their way over the back fence to this old woman's house because their family is going through all sorts of its own trauma. So the safe houses themselves are not institutionally constructed with code or public services sitting there waiting for the client to arrive. These are receiving places within their community, built on a strong cultural base and on strong relationships, either personal or otherwise. These are the champions in our community—these mothers and these grandmothers and these other people that dwell in these houses. They're the ones doing the heavy lifting, not government departments or service providers. They have certain statistical outcomes but, if you were really being truthful, spend 24 hours in one of these houses. You see the turnover, the duty of care, the counselling, the love and the support that these old grannies are giving to these children in crisis. That's where the rubber hits the road in this context. You asked the question: what are the cultural solutions? There is one. There is not going to be one model that fits everything. It's about reacting to the situation.

Senator O'NEILL: In place.

Mr Barker : Yes. What is happening now? What is it for this cohort of young people? What's happening about young women who are 13, 14 or 15, are about to have children and are traumatised with drugs and domestic violence? Where's the action on their ground? Where do they communicate? How do they get a chance at real life? They don't, because the society in which they live is so traumatised and continues to build the trauma day in and day out. While we're all talking about solutions, these grandmothers and these community safe houses are doing it. They're the champions we should be supporting.

CHAIR: I'm very aware of time, but we've been pushing the time barriers on this inquiry very significantly in terms of wanting to hear from people. I hear what you're saying. What does that support look like? We've been having some discussions with people during the hearings. How do you give support to the people who are doing what you said?

Mr Barker : There are 152 agencies delivering services to one Aboriginal person every year. You can't tell me that 50 of them can't sit together around a table and work out a solution to help an old lady feed the multitudes that come through her door, and provide a hotline to the ambulance and medical services for the children who are in trauma—a raped child or whatever the case may be. You can't tell me that 50 people in that cohort, who are funded by the government, can't find a solution.

CHAIR: To build a network around that safe—

Mr Barker : This is what we're proposing.

Senator PRATT: I will give you another example that you might draw on: the quite successful range of programs that exist in the Kimberley. Might there be other culturally determined models where you can put buckets of money together that might otherwise have gone to other sources to deliver social and community outcomes that are organised along cultural lines? Is that the kind of thing that you have in mind?

Mr Barker : Certainly, Senator. What I'm saying is that you've got to look at multiple models. There is not one. If you took the rangers as an example, the rangers are an empowered group of people. They don't really need a lot of help. They're really empowered themselves. They're strong men and women who go out and look on country. As a service, they offer an opportunity as a vehicle to take other disenfranchised youth with them.

Senator PRATT: But surely we should have empowered groups of people who are strong culturally and are motivated to come together to provide health and community services under a similar kind of model, including grandmothers.

Mr Barker : Just to answer your question, we have multiple organisations that do multiple things. What we don't have is a strategic operational plan around how we enact and take the best value out of all of that. There are rangers, safe housing projects, the things that the police are doing, the Wirrpanda Foundation, and small groups like the suicide prevention group in Derby, for example. Everyone's got these models. What we need to do is bring them all together, have a strategic plan with a little bit of money that we can spend, try to make some real dividends and see, on a trial basis, what works.

CHAIR: That's the point that you made in your comments about the strategic plan. Mr Hayward, I promised I'd come to you.

Mr Hayward : Thank you. The most important thing is that both Commonwealth and state governments invest in local and state based places and Aboriginal self-determination is actually invested in and nurtured and grown from a government perspective. The question of capacity is irrelevant. We have that capacity. What we need is investment across governance, leadership, management and frontline service delivery. We have our own answers. The truth is we live with trauma and we understand it and we have the solutions for our own community, but it can be an overarching framework to address the intergenerational trauma and the current trauma in the modern society. The people who have the answers are the leaders and the service providers within those communities themselves. What is frustrating for the Aboriginal community across the nation is that that is in question. There should be no question. There should be investment and building of the solutions for our people. It's quite simple. We can have an overarching framework to sit with our community and talk about our own intergenerational cycles, hold our own people to accountability, create healing and be responsive and reflective of our own people's needs. A right delayed is a right denied. The investment and the solutions are before the government and before the decision-makers and the influencers who have that power. So, there should be no inquiry and there should be no royal commission; there should only be investment in the solutions for a better way.

Senator O'NEILL: Ms O'Meara, can you put your perspective, as a woman, on the record about the nature of the conversation we've had about suicide prevention and cultural solutions.

Ms O'Meara : Yes, sure.

Senator O'NEILL: Especially because you've got an Irish surname!

Ms O'Meara : It's a good mix! The women in the communities are bearing the burden a lot of having to care for families that are going through mental stress, trauma and suicide. Our elders have been cutting our children down. More than 10 years ago we bought up a specialist in the area of Indigenous psychological services, Dr Tracy Westerman. Over 10 years ago she came to the Kimberley, and she was the person who the Kimberley young people responded to the best. They said: 'You're the one who's talking our language. You understand what we're telling you, and we understand the answers you're giving us on how we can look after our mates and how we can protect ourselves. We've been told a lot of different information from a lot of different services—Aboriginal and non-Aboriginal—and they don't make sense.' They put up a petition to Carol Martin, who was the member for Kimberley at that time. It went away and it came back looking quite different, and Tracy has never been given a government contract for work in the Kimberley or work in this state. I think it's appalling. She's one of the top three Aboriginal suicide experts in the world. Canada gobbles her up, and Western Australia doesn't invite her in. I find that absolutely appalling. I find it appalling mostly because it came from elders and it came from young people at a workshop that we held in Derby.

We talk about that stuff around institutionalised racism, and, Senator Pratt, you also asked about people generating it themselves. Well, they do. As soon as they get to a level where they feel that they're empowered—and women drive this really well, particularly around the concerns for community—they get to a point and then it's just knocked back. So none of the ideas and the cultural frameworks fit within the government structures or within any of the funding structures that sit with the not-for-profits, whether they are Aboriginal or non-Aboriginal NGOs. And the frustration—

Senator O'NEILL: With the formal structures, you're saying that they get to a management position, but they're not at the decision-making table?

Ms O'Meara : They're not at the decision-making table—exactly. We have conversations about the men, because they've been able to work and get out of that dynamic of the family. They've been able to go out and work and interact at a more senior level, like my colleagues here, in the past, more so than women. They can actually take a break from the pressure and the trauma, whereas the women live it and have to deal with it every day. We see the old grandmothers who can barely walk. They're not mobile, but they're looking they're looking after more than one grandchild. They're living in overcrowded conditions. They've got family converging on them and overcrowding their houses. They've got young people passing through, couch surfing. This is the reality for women and for the families that live in Aboriginal communities—and the men; they have to live this as well. So it is extremely difficult. Marty raised the fact that the national partnership on Indigenous remote housing—

CHAIR: It's still in the air.

Mr Sibosado : That agreement has expired. We are in limbo. We're still short by quite a number of houses for Aboriginal people in remote areas, and not only the houses but the services that need to go with them.

We do have a model, and I'd like Marty to talk to that. This is the model that we talked about. We've been travelling around. This is a 20-year model or more. Both Mr Sibosado and Mr Barker over here know the model, and we talk about Kimberley Futures. I'll give that over to Mr Sibosado here.

Mr Sibosado : We started off talking about the cultural approach of having a look at the way we deliver programs, and we've heard all that. Kimberley Futures is reflected at this stage. We're 86 per cent native title determined. It's not about native title; it's about the cultural framework. We've said this before. We've established in the federal courts that we've continued on our cultural practice, and that's our framework. We don't make that correlation of saying the Kimberley is now 86 per cent determined native title. The average person wouldn't understand that. What you have to prove in the court is your continued practice and connection to your culture and your country. So that's very strong for us. When we talk about Kimberley futures and family empowerment and using a cultural framework, we want to get back to what we know as Kimberley Aboriginal people. Our culture is very much central to what we do. We've been a bit lost, like everybody, with the right to drink and that period of some freedom. Equally, now we want to get back to that framework and use it as a model, because we know it works.

But, as I say, the disconnect is with, if you like, the government, who are the leaders and the elected people in the Westminster system, which is not an Aboriginal system. When we talk about co-design, we're saying, 'Well, we've got something to contribute, but you don't want to listen to us, because of superiority of your systems and your service delivery.' Quite frankly, after 10 years of Closing the Gap and significant billions of dollars of investment, quite clearly we're no closer to reaching that equitable position.

So a bit has to be given, but we want to go back. We have the systems and the frameworks, and I'd say it'd be the same in the Pilbara and other areas. If you like, our people are becoming a lot more empowered and a lot more educated. So we want to trial our system that we understand, which is centuries old. Yes, modernise it a bit to fit to the government's sought outcomes, but let us work out how to deliver that, because we're never given that. We're just service providers with a policy and a program that's set by people in Canberra or Perth. As service providers, you have to follow that or you risk not being funded. Everyone needs resources. So, with Closing the Gap and partnerships and all these wonderful words around working together, that would be our position: saying, 'Well, we have a cultural framework; we have a culture that's a long way older than yours.' Yes, we want to interpret that, and we all seek to achieve the same outcome.

So things like Kimberley Futures are really about going back to our cultural frameworks—it's those sorts of things you'd all be familiar with: Yawuru people can't talk for Bardi people—and, to a degree, empowered communities around place based decision-making. So we're using, if you like, Western language to try to say, 'Look, we want to go back to our culture.'

Senator O'NEILL: Try to help us understand.

CHAIR: I've run us quite a bit over time. We still want to make sure we hear from our other witnesses. Have you got something further on that that you could provide to the committee?

Mr Sibosado : Yes.

CHAIR: Okay, that'd be fantastic. I have one question—I have lots, but I have one I want to ask now of Ms Lightfoot. During these hearings, we have heard that some clinical practitioners will not allow an interpreter into counselling sessions.

Ms Lightfoot : Did they give a reason?

Senator O'NEILL: It sounded like power.

CHAIR: What I took from what we heard was that they were trying to argue privacy and those sorts of issues.

Ms Lightfoot : Yes, that's what I assumed. Basically, it really highlights the need for training and awareness of the role of interpreter. It's really unfortunate and it's not confined to this space, but people don't understand that interpreters are actually professionals, as are doctors, as are health workers. Interpreters have a code of ethics including: impartiality, accuracy, confidentiality et cetera. As they approach any job, they are obliged to notify the clinician and also the client of these codes of ethics. Unfortunately, it gets chopped off before there's even an opportunity for that. So whoever is making those statements might need to do a little bit of research in regards to the language service policy that they need to be abiding by.

CHAIR: As I said, I was quite shocked to hear that for all the reasons you articulated earlier.

Ms Lightfoot : We will make a formal submission but I guess I can read through the transcript and find who said that. But it's generic across the board. There's a major misconception about the role of interpreters and it's really unfortunate. I'm really pleased to say that the current government are interested in also standardising the use of interpreters and see that they are actually critical in the use of day-to-day services across the board. And they are looking at ensuring all government services pay more attention to and abide by the language service policy that they are meant to be.

CHAIR: Thank you. Anything further that you want to add once you've had a look at the Hansard, we'd really appreciate it.

Ms Lightfoot : Sure, no problem.

CHAIR: Thank you so much for your time today. We very much appreciate it.