National Close the Gap Day

The Hopkins Centre have made many contributions to closing the life expectancy between First Australians and non-Indigenous Australians. Partnering with First Australian communities to achieve communities' research goals is a core component to addressing First Australian health disparities. These research projects provide a synopsis of some of the work The Hopkins Centre has engaged with.

Improving Compulsory Third Party (CTP) Scheme for First Nations People in Queensland

The experiences of First Nations Australians injured in motor vehicle accidents is not well understood. Many injured people do not realise that they may be eligible for rehabilitation and compensation through the CTP scheme in Queensland if they were injured in a motor vehicle accident that was not their fault.

Our project, funded by the Motor Accident Insurance Commission, aims to:

• Identify the factors that influence First Nations Australians who have experienced a motor vehicle accident to seek compensation, treatment and rehabilitation through the CTP scheme;
• Learn how First Nations Australians experience the CTP claim, treatment and rehabilitation process;
• Investigate how the CTP scheme can work in line with First Nations knowledge systems to improve the CTP experience and outcomes; and
• Understand the role of Elders and trusted advisors in the context of a CTP claim.

The project will assist by identifying:

• Ways of encouraging First Nations Queenslanders to seek compensation and rehabilitation through the CTP scheme; and
• Opportunities to improve the CTP experience of First Nations Queenslanders who are injured in motor vehicle accidents;
• How First Nations knowledge systems can be used to improve the rehabilitation outcomes for First Nations claimants.

For more information contact https://www.hopkinscentre.edu.au/contact

Preventing First Nations Deaths by Suicide

The First Nations community in the region of Mackay, Queensland have a long-standing partnership with Griffith University to address First Nations deaths by suicide. This partnership was triggered by a cluster of youth suicides that devastated the community. In 2020, the partnership developed the ‘First Australian Holistic Health Multi-Dimensional Model of Suicidal Ideation and Suicide-Related Behaviour”. Working with the community, we developed a First Nations holistic health framework to analyse the suicidal ideation and suicide-related behaviour experiences of 14 First Australian residents of the Mackay region.

The analysis resulted in the development of the Empowerment to Prevent Suicidality (EPS) Model. The EPS Model explains how participants’ experiences of powerlessness occurred within the complex context of their life circumstances to reach a point of saturation, leading to suicidality. It also explains how the counteracting experiences of empowerment could generate a positive disposition and support recovery. The model can help in identifying and addressing both the broad context and individual circumstances that can predispose First Nations people to suicide-related behaviours or thoughts.

For more information contact Dr Leda Barnett at l.barnett@griffith.edu.au

Assessing the Needs of Indigenous Prisoners with Disability

There is a need to better identify the needs of First Australian prisoners at the time of intake and have these needs inform prisoners’ pathways to employment upon release. As part of a national plan to improve outcomes for First Nations prisoners with disability, this project focused on the identification, assessment, treatment and follow-up of adult First Nations prisoners and ex-prisoners with ‘hidden disability’. Hidden disability includes disabling conditions that are common but often unnoticed and not diagnosed (e.g., hearing loss and cognitive impairment, such as Foetal Alcohol Spectrum Disorder or Acquired Brain Injury).

The findings revealed major challenges for disability identification and assessment in Australian prisons due to lack of training, time pressure and limited staff with cultural knowledge. During incarceration, additional challenges included the availability of modified programs, a criminogenic focus rather than a focus on rehabilitation, confusion about how NDIS interfaces with corrective services and inadequate or untimely transition planning. Consultations with First Nations community members with prison experience revealed over 180 distinct solutions highlighting the importance of culturally informed processes throughout the prison pathway.

Access the report at https://www.dss.gov.au/disability-and-carers/assessing-the-disability-needs-of-indigenous-prisoners

First Nations Recommendations for Improving NDIS Plan Utilisation in Queensland

First Nations Queenslanders with disability participated in this Queensland Government DSDATSIP research about how their NDIS plans were being utilised. Thirty-five (35) First Nations people with disability shared their experiences, 13 of whom lived in very remote communities.

The findings showed that many of these First Nations people with disability experienced harm within the NDIS system, caused by a lack of respect for First Nations perspectives and values. Many believed that their sexuality, gender or cultural needs were not honoured within the NDIS system.

Some solutions proposed directly by First Nations participants included;

• Employing more First Nations providers in the NDIS system;
• Providing First Nations NDIS information sessions and resources;
• Enhancing the cultural awareness and sensitivity of the non-Indigenous workforce through ‘on country’ immersion and understanding of safety requirements relating to cultural needs;
• Providing specific culturally-sensitive support to help First Nations people to understand their NDIS plans;
• Improving the numbers of local and culturally-informed (or First Nations) planners and coordinators who can provide face-to-face services;
• Enabling flexibility in service delivery to address the challenges of limited supply of First Nations services;
• Enabling innovative models of service delivery that enable First Nations people to be supported by First Nations providers and support workers.

For more information contact https://www.hopkinscentre.edu.au/contact

First Nations Self-Management of Chronic Disease

This study investigated the cultural appropriateness of the Stanford Chronic Disease Self-Management Program (SCDSMP) for use in First Nations communities in regional, outback and metropolitan Queensland. Using a participatory approach, focus groups and interviews were conducted with Elders, First Nations and non-Indigenous health professionals and First Nations community members with chronic conditions.

This research showed that First Nations engagement with the medical system was influenced by five core principles; historical factors, the collectivity of First Nations community life, the First Nations concept of holistic health, the lack of cultural competence within the health system and the use of culturally inappropriate communication styles at the interface when First Nations people attended appointments. In addition to these broad factors, specific local health promotion differed across regions due to the unique features of each community. The way in which programs were accepted and used in regions depended on the nature of local systems (the interacting roles of gender and community Elders), cultural traditions and knowledge, local cultural communication styles, levels of community participation and First Nations leadership. How these local principles and broad overarching factors interacted reflected the different priorities and issues within each community, ultimately influencing the effectiveness of the delivery of the SCDSMP.

The associated journal articles from this research include:

Kendall, E. and Barnett, L. (2014). Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy. Ethnicity and Health, 20:5, 437-452, DOI: 10.1080/13557858.2014.921897

Barnett, L., Kendall, E. (2011). Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs. Health Promotion Journal of Australia, 22(1), 27-32, DOI: 10.1071/he11027

For more information contact Dr Leda Barnett at l.barnett@griffith.edu.au

Dr Leda Barnett