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Report on the NSW Government's Implementation of the Recommendations of the Royal Commission into Aboriginal Deaths in Custody
Appendix D
Area Health Service Initiatives
Central Coast Area Health Service (CCAHS)
Implementation of plans and policies The Central Coast Aboriginal Health Strategic Plan continues to be implemented. A review and evaluation of the plan is currently in progress.
Alcohol and other drug abuse A full time Aboriginal and other Drug Liaison Officer is working as an advocate for Aboriginal and Torres Strait Islander clients and their families. This worker is involved in the development and implementation of educational programs including distribution of brochures, the presentation of programs in schools and a health gathering.
Data collection Identification of Aboriginal and Torres Strait Islander Patients/Clients has been an area that requires constant attention by staff in particular the Hospital Liaison Officer. The Hospital Liaison Officers see all Aboriginal and Torres Strait Islander inpatients from Monday to Friday.
A protocol has been developed to record and adjust ethnicity when it is recorded incorrectly by admission staff.
Community education An Aboriginal Health Service Directory has been developed and distributed to inform the community of the range of services that are available. The directory includes methods of referral/access, waiting times and eligibility. Nunyara Aboriginal Health Newsletter is distributed quarterly. Each publication contains information on health issues, access to health services, health programs and events and services that are available on the Central Coast. The newsletter is distributed to Aboriginal Organisations, government and non-government organisations and schools.
Links with Juvenile Justice Aboriginal workers regularly liaise with the Department of Juvenile Justice to develop and implement health programs. The Aboriginal HIV/Sexual Health Educator attends Mt Penang each fortnight and presents workshops for the detainees. The Aboriginal Alcohol and Other Drug Liaison Officer will be participating in these workshops during 1999.
Funding Aboriginal Health Enhancement Funding was received from Aboriginal Health Branch, the majority of this was allocated to the Yerin Aboriginal Health Services to enhance the health services offered to the local Aboriginal and Torres Strait Islander community.
Programs Programs currently being implemented include:
- Otitis Media Implementation Plan – The Otitis Media Taskforce continues to develop initiatives to implement this strategy;
- Family Health Strategy – A working party has been formed and a submission has been lodged to secure funding to implement this strategy;
- an Aboriginal Mental Health Registered Nurse has been employed. His role is to manage a client caseload as well as being involved in community education.
Mid North Coast (MNCAHS)
The MNCAHS Aboriginal Strategic plan is being finalised. Achievements include:
- establishment of an interagency/intergovernmental working party on Aboriginal health in Coffs Harbour;
- an Aboriginal health clinic operating three days a week at Coffs Harbour;
- establishment of a transport system to assist people to access the clinic;
- expansion of the Aboriginal Health traineeship program through a joint exercise with Yarrawarra Aboriginal Corporation;
- research and development of an Aboriginal Health/Community Survey;
- joint initiatives between Health and Ambulance to promote first aid courses and first aid kits for graduates;
- renegotiated agreement to provide partnership and clinical training for three Aboriginal mental health worker trainees;
- drug and alcohol workers regularly visit Purfleet/Taree community and liaise/advise newly appointed Aboriginal Alcohol and Other Drug worker at the Biripi AMS;
- development of a formal Partnership Agreement on Aboriginal Health between MNCAHS and Durri and Biripi AMS’s;
- development of a Partnership between MNCAHS, Durri AMS and Booroonjun Aboriginal Corporation for the establishment of a renal satellite unit; and
- draft Area Alcohol and Other Drug Strategic Plan incorporating early detection and secondary prevention procedures for Aboriginal people.
Mid Western Public Health Unit
Achievements include:
- establishment of the Mid West Wiradjuri Area Health Council. The Council has Aboriginal representation from all Aboriginal communities serviced by the MWAHS and is the peak advisory group on all Aboriginal health issues in the Area;
- appointment of permanent Aboriginal Health Education Officer in Bathurst to the assist local Aboriginal community to access culturally appropriate health services;
- permanent filling of Aboriginal Health Education Officer positions in Cowra and Orange;
- local Aboriginal Health Advisory Group set up in Orange, comprising local Health Service Management and Aboriginal community leaders to discuss possible strategies to the improve the health of Aboriginal people residing in Orange;
- development of Aboriginal Health Strategic Plan with full consultation with Aboriginal communities and organisations within the MWAHS;
- development of draft Aboriginal Men’s Health report informed by an Aboriginal men’s focus group in all Aboriginal communities in MWAHS;
- Aboriginal youth health and education expo held at Parkes for three days to raise awareness of health issues and highlight career opportunities for Aboriginal youth who are contemplating leaving school to enter the workforce;
- the provision of culturally appropriate monthly sexual health clinics to Aboriginal communities in Cowra, Condobolin and Murrin Bridge;
- close working relationship with the Division of General Practitioners has been developed, leading to a draft submission that will assist local doctors to work more closely with local Aboriginal communities and clients;\
- extensive consultation has been undertaken at Murrin Bridge to assist with the development of a Health Service Plan that meets the health needs of the local Aboriginal community;
- a joint submission between MWAHS and Yoorana Gunya Aboriginal Family Violence Healing Centre to the NSW Department of Health has been made for funds to assist this organisation set up their service to target Aboriginal families in Murrin Bridge, Lake Cargelligo, Condobolin, Forbes, Parkes and Peak Hill; and
- a two day information session and workshop involving Aboriginal representatives from all Aboriginal communities serviced by the MWAHS, senior management of MWAHS as well as the Chief Executive Officer, NSW AHRC, NSW State Director, Aboriginal Health and Deputy State Director, Commonwealth Health and Family Services, Aboriginal Health Programs.
Northern Rivers Area Health Service
A comprehensive Area Aboriginal Health Strategic Plan was completed for 1998-2002 with major objectives in the areas of drug and alcohol, mental health, culturally appropriate services and employment. An Aboriginal Family Health Strategy to reduce family violence and sexual assault is being implemented. In particular a joint initiative with the Department of Community Services and Probation and Parole is making significant progress. The Aboriginal Employment Co-ordinator position has been effective. Recurrent enhancement funding has been secured for new Aboriginal Health worker positions; one in drug and alcohol and three as community development workers. Support for workers has been improved.
The Bungalweena Team in Tweed Heads is providing 24 hour access for Aboriginal and Torres Strait Islanders to volunteer Mental Health Services. Koori Adolescent Camps are reinforcing younger people’s identity giving them both pride and self confidence. A new Aboriginal Medical Service in Casino and two Community Health Posts at Jali (Cabbage Tree Island) and Muli Muli (Woodenbong) are now providing for community needs.
Aboriginal Elders are involved in conducting cultural awareness programs for health staff and a cultural awareness website has been established to support this initiative. Yugambeh Darung has been completed. This project assisted communities to develop self help strategies relating to misuse of alcohol and other drugs. Sustainability was a major goal and a number of local projects have been established as a result.
Other ongoing initiatives to improve Aboriginal health include:
- Shared Vision workshops for community self determination and sufficiency;
- Aboriginal heart health screening;
- diabetes camps;
- market gardens;
- accredited first aid training for staff;
- immunisation clinics;
- STD/HIV programs; and
- Spiritual (mental) health groups.
Southern Area Health Service
The Area has developed local Aboriginal Health Strategic Plans in consultation with Aboriginal communities. Aboriginal people have been appointed to Southern Area Health Service Area health councils. There are also Aboriginal representatives on the ethics, domestic violence, and youth centres committees.
Achievements include:
- employment of Aboriginal and Torres Strait Islander alcohol and other drug counsellors;
- health education workshops on substance abuse;
- training run with police officers from Yass Police Station; the Aboriginal Educator from Goulburn Police Academy has been involved in training local police across NSW;
- advocacy service set up in accordance with the Memorandum of Understanding between NSW Health and NSW Police; An advocacy service has been set up for Aboriginal people in custody.
A community representative may be called on to advocate on behalf of the person. The local police were also provided with practical ways of improving the relationship with the local Aboriginal community, in particular it was suggested that they build close links with the Youth Centre (90 per cent of those attending are Aboriginal Youth), being seen as approachable and not just turning up when young people are wanted for questioning;
- local health newsletter to the Yass Aboriginal community covering various laws as well as an information update on health related matters;
- the Aboriginal Mental Health Worker for Yass was nominated by the local family as a support person for a young offender under a youth justice conference outcome plan. An outcome of this was that she was also nominated as a responsible person to oversee that the person went on to complete the activity agreed upon by the offender and victim;
- production of the Southern Area Health Service reconciliation and mental health pamphlets;
- production of the Southern Area Health Service cultural access package;
- formal links between Aboriginal workers in mainstream services with local land councils and Aboriginal housing corporations;
- Aboriginal after-school program run between the health service and local schools; children are identified through the school as needing extra assistance and they attend the after school group. The Speech Pathologist and the Aboriginal Health Education/Liaison Officer work on a literacy and language program suited to the learning styles of Aboriginal children;
- focus groups and interviews conducted with Aboriginal women regarding cervical screening;
- introduction of Aboriginal health workers bi-annual meeting; and
- formation of a mental health workers forum to address the implementation of Aboriginal mental health policy.
Central Sydney Area Health Service
King George V Hospital has a well-established midwifery service offering antenatal and perinatal care for Aboriginal women and children. The service is co-ordinated by a Senior Aboriginal Midwife and is regularly accessed by the Aboriginal and Torres Strait Islander communities of NSW. Central Sydney is currently undertaking a feasibility study to increase access to CSAHS birth centre services by Aboriginal women.
The Aboriginal Family Home was developed in 1996 to provide accommodation for Indigenous patients and families of rural communities.
Aunty Polly Smith Centre, Redfern, an outreach alternative women’s health service, was established to provide antenatal and prenatal services to Aboriginal communities of Central Sydney. Based in Redfern, the Centre offers a wide range of services for Aboriginal mothers and their children, including early childhood, child protection and playgroup activities. This program is managed by an Aboriginal nurse and two Aboriginal Health Education Officers employed by Central Sydney Area Health Service.
Redfern Community Health Centre provides a comprehensive service to the Aboriginal and Torres Strait Islander community. Aboriginal Health Education Officers run programs and initiatives daily on a range of topics including: sexual health; alcohol and other drugs; and Otitis Media. This service has proved positive in facilitating access for residents of Waterloo and Redfern Aboriginal communities to mainstream services.
Connect Redfern is an intersectoral program involving the Departments of Health, Education and Training and Community Services operating in Redfern to assist families in ensuring their children are ready to start school.
An Aboriginal Mental Health Unit has been established in CSAHS to assist every Aboriginal person who is referred to the Mental Health Service. Aboriginal Mental Health professionals provide fortnightly prison clinics to Long Bay. Aboriginal professionals from Central Sydney have had direct involvement with decision making regarding releasing inmates for funerals and family commitments.
The Community Mental Health team are on call for Aboriginal and Torres Strait Islander families throughout Central Sydney providing programs and initiatives for families with mental health problems. There are two mental health nurses working with adolescents, who have a significant youth caseload.
Aboriginal Mental Health professionals provide support and education to mainstream workers on Aboriginal issues. They are currently training two trainee psychiatrists on fellowship to CSAHS in Aboriginal Mental Health issues.
Illawarra Area Health Service (IAHS)
Development of a Draft Partnership Agreement with the IAHS and Aboriginal Community controlled Health Service has been endorsed by the IAHS Board. The agreement will soon be signed.
A partnership between ACT Health and the IAHS provides specific health programs to the Aboriginal community living at Wreck Bay and Jervis Bay.
Achievements include:
- Aboriginal participation in policy and strategic planning through the Aboriginal Health Advisory Council and Hospital Liaison Committees;
- cultural awareness training for staff about Aboriginal issues at all levels of the IAHS;
- an intersectoral committee has been established and meets regularly to address issues relating to youth and their families. As a result of this initiative a six month pilot project with IAHS, the Department of Community Services and Juvenile Justice is near completion and will be evaluated;
- an intersectoral approach to a needs analysis has been completed for the Aboriginal Family Health Strategy. The results of this were forwarded to the Aboriginal Health Branch for allocation of funds for the Area project;
- the first Aboriginal pre-school was established and opened in the Shoalhaven;
- development of a Child Health Program to ensure better co-ordination. Key focus areas are: Otitis media, immunisation and pre-school screening. Approximately 356 Aboriginal school aged children were screened for Otitis media in 22 schools with follow-up evaluation of the program in progress;
- an Aboriginal Resource Manual is in draft form. The manual aims to assist in the provision of culturally appropriate health services for Aboriginal people;
- a review of the implementation of the Aboriginal Hospital Casualty Review was conducted and recommendations made to assist with further implementation;
- the appointment of new Aboriginal positions to: mental health, drug and alcohol and a community health worker located at Orient Point. Also special project officers to address child health, cervical screening, post natal depression and suicide prevention;
- the commencement of an Aboriginal Traineeship Program in clerical and health support within the hospital setting;
- the results of the Aboriginal Health Advancement Survey have been evaluated and a report produced. This report was presented and explained to the Aboriginal communities;
- the Sexual Health Service provides outreach programs to the Aboriginal community;
- HIV prevention conducted a twenty week train the trainer course which offered education on HIV prevention, drug and alcohol use and crime prevention;
- a collaborative approach between the Aboriginal Community Controlled Health Service and the Illawarra Area Health Service in developing a program to address issues related to pregnancy and birthing for Aboriginal women. Intended outcomes are to reduce the perimortality rates and to increase the number of Aboriginal women breast-feeding. Ante-natal programs operate at Aboriginal Medical Service, Wollongong and extend to the Aboriginal community in the Shoalhaven;
- special projects aimed at improving access to cervical screening service for Aboriginal women and developing culturally appropriate resources in post-natal depression;
- ongoing program with breast screening and education for Aboriginal women; and
- ongoing meetings with all Aboriginal Health Services with the Division of General Practitioners in the Shoalhaven to address Aboriginal health issues and improve co-ordination and collaboration.
New England Health Service
All of the major hospitals in the Area have an Aboriginal Liaison Committee. These Committees have representation from the health services as well as local representation from other groups such as the Community Employment Programs and ATSIC.
A comprehensive survey of 10 per cent of the Aboriginal population was carried out to identify the community’s priority areas. These priorities will form the basis of the Aboriginal Health Strategic Plan.
An Aboriginal Liaison Officer is employed in all towns with a significant Aboriginal population. Their role is being extended to include community development in those areas that do not require a full time position.
There has been an increase in the number of Aboriginal mental health (liaison) staff employed in the Area. Their role is to provide counselling and facilitate access of Aboriginal clients to mental health services.
The Aboriginal Maternity Service has been extended and the position of midwife has been advertised.
The role of the Aboriginal Health Education Officers has been further developed so that they provide health assessments that cover the major causes of death in Aboriginal communities such as diabetes, heart disease and cancer.
The services of a podiatrist have been extended to Pius X Aboriginal Corporation in Moree from the Area Health Service.
Women’s health services continue to be offered from a number of community organisations in the Area and are proving to be very successful. This service will be expanded over the next twelve months.
The Public Health Unit has been liaising with the Department of Aboriginal Affairs, ATSIC and the Moree Local Aboriginal Land Council to ensure that basic repairs to Mehi Crescent and Stanley Village are carried out. This includes work on the sewerage systems, electrical services and essential repairs to the houses themselves.
In conjunction with the Toomelah Local Aboriginal Land Council, the Public Health Unit is carrying out health education programs.
South Western Sydney Area Health Service
Achievements include:
- establishment of Aboriginal Health Service Teams in Macarthur Sector and Northern Sectors;
- establishment of an Aboriginal Women and Children’s Health Clinic at Miller which runs an Aboriginal Medical Service as part of its program;
- establishment of an Aboriginal Child Mental Health Program which is conducted in partnership with a Kuta Gulls Aboriginal Pre-School at Liverpool West;
- the provision of Cultural Awareness Training for senior Area and Sector staff;
- employment of an Aboriginal Project Worker to review the Strategic Plan for Aboriginal Health in South Western Sydney;
- an Aboriginal Diabetes Clinic established in partnership with the Gandangara Local Aboriginal Lands Council;
- establishment of Aboriginal Men’s Health Clinic at Miller Community Health Centre in partnership with Corrective Services Drug and Alcohol Unit;
- the evaluation of the 1993 Strategic Plan for Aboriginal Health in South Western Sydney completed in November 1998;
- the expansion of the Aboriginal Diabetes Clinic to include the Aboriginal Women’s Health Clinic and the Aboriginal Men’s Health Clinic at Miller Community Health Centre; and
- the establishment of an Aboriginal Youth Peer Education Drug and Alcohol program in Macarthur Sector.
Western Sydney Area Health Service
Western Sydney Area Health Service (WSAHS) recognises that all of their services must be accessible, culturally sensitive and responsive to the changing and growing needs of the Aboriginal community.
WSAHS continues to conduct Aboriginal Cultural Awareness courses throughout the Area for non-Aboriginal staff, trainee nurses, medical students and the Royal College of General Practitioners. This is an ongoing program.
Mental Health Services have been delivered with the support of WSAHS, through Daruk Aboriginal Community Controlled Medical Services, and funded through the Burdekin Report. A new partnership has been forged with Wentworth Area Health Service and Daruk
Aboriginal Medical Service to jointly provide support and deliver mental health services to the Aboriginal community.
Drug and Alcohol Services are delivered with the support of the Daruk Aboriginal Medical Service. WSAHS Drug and Alcohol Unit was successful in acquiring funds from the “Drink – Drunk the Difference is U” campaign and have, in conjunction with Juvenile Justice, Daruk AMS and Mudarra Aboriginal Youth Hostel, developed an alcohol related violence package now called the “NO MORE” package.
The package has been launched and training sessions for people working with Aboriginal Youth have commenced.
In February 1998, WSAHS, WAHS, and Daruk AMS in Partnership with the Department of School Education and Training, Durali Aboriginal Centre (UWS, Nepean), the NSW Cancer Council and WESDARC, jointly hosted the first Aboriginal Youth Drug and Alcohol Forum, to seek their views on how we should address their health needs and associated problems. One of the major outcomes of this forum was the establishment of an Aboriginal Youth Health Advisory Council (AYHAC) which will provide advice and support to the Area.
HIV/AIDS and Sexual Health units have delivered joint programs with Daruk AMS, and have employed an Aboriginal sexual health worker to carry out research and a needs assessment on the sexual health of the Aboriginal community in the Western Sector. This report will be completed in the next few months.
The Department of Health AIDS Unit has funded a new Aboriginal identified position for a Sexual Health Clinical Liaison Officer to cover the WSAHS and WAHS in partnership with Daruk AMS.
WSAHS in partnership with WAHS and Daruk AMS seeks to address the health needs of Aboriginal Elders in the community, by organising events such as the Aboriginal Elders Expo, and the Aboriginal Elders Christmas Luncheon in December.
The Aboriginal Community will continue to have input into WSAHS policy through their Aboriginal representative on the Board of Directors.
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