tag:theconversation.com,2011:/africa/topics/indigenous-suicide-28738/articlesIndigenous suicide – The Conversation2019-08-26T07:58:28Ztag:theconversation.com,2011:article/1224012019-08-26T07:58:28Z2019-08-26T07:58:28ZPolitics with Michelle Grattan: PM’s advisor Christine Morgan on tackling Australia’s rising suicide rates<figure><img src="https://images.theconversation.com/files/289411/original/file-20190826-8860-1wlnvji.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Christine Morgan points to the value of the brand of Headspace for young people; they know "this is a place I can go".</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/london-united-kingdom-october-05-2018-1197504028?src=TXFt85ddEZEjCC6BKAWXwQ-1-1">Shutterstock</a></span></figcaption></figure><p>The number of suicides in Australia <a href="https://www.theguardian.com/australia-news/2018/sep/26/australias-rising-suicide-rate-sparks-calls-for-national-target-to-reduce-deaths">has been rising</a> in the last decade, with more than 3,000 Australians taking their life in 2017, according to the latest available ABS figures. Some of the most vulnerable groups include Indigenous Australians, young Australians, unemployed people, and veterans. </p>
<p>Scott Morrison has declared this a key priority area for the government. He has appointed Christine Morgan, CEO of the National Mental Health Commission, as the national suicide prevention advisor to the prime minister.</p>
<p>On this episode, Christine Morgan speaks with Michelle Grattan about the issue - what we know so far, and what needs more clarity. She stresses the role of communities in tackling the rising rates, and also argues for a more holistic view - beyond narrow mental health problems - of the factors that drive people to contemplate taking their own lives. </p>
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<p>Yes, it may be that they’re suffering from a mental health condition. Yes, they may be suffering from a health condition. But they may also be being affected by other things which significantly impact, like what is their housing security?[…]What is their employment situation? what is their financial situation? Have they come from a background of trauma?</p>
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<p><em>Anyone seeking support and information about suicide can contact Lifeline on 131 114 or Beyond Blue on 1300 224 636.</em></p>
<h2>New to podcasts?</h2>
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<p>You can also hear it on Stitcher, Spotify or any of the apps below. Just pick a service from one of those listed below and click on the icon to find Politics with Michelle Grattan.</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
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<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="http://freemusicarchive.org/music/Lee_Rosevere/The_Big_Loop_-_FML_original_podcast_score/Lee_Rosevere_-_The_Big_Loop_-_FML_original_podcast_score_-_10_A_List_of_Ways_to_Die">A List of Ways to Die</a>, Lee Rosevere, from Free Music Archive.</p>
<p><strong>Image:</strong></p>
<p>Shutterstock</p><img src="https://counter.theconversation.com/content/122401/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>On this episode, the PM's national suicide prevention advisor speaks with Michelle Grattan on what we know so far about suicide rates, and what needs more clarity.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1172612019-05-23T04:26:44Z2019-05-23T04:26:44ZAustralia has been silent on Indigenous suicide for too long, and it must change<figure><img src="https://images.theconversation.com/files/275840/original/file-20190522-187179-14zf6d0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Following the deaths of an alarming number Indigenous young people earlier this year, Australian leaders were urged to declare a 'national crisis'.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/clearly-milky-way-found-australias-outback-673112455">Shutterstock</a></span></figcaption></figure><p>A body hangs over me. I am so close I can feel there is weight to the body. It seems to twitch in the stagnant air of the theatre with the last tendrils of spirit. There is nowhere to avert my gaze. I remind myself this is the point: to feel the overwhelming sickness and powerlessness Indigenous people so often feel.</p>
<p>I am sitting watching Jack Sheppard’s performance of <a href="http://lamama.com.au/2019-summer-autumn-program/the-honouring">The Honouring</a> for the Yirrimboi Festival in Melbourne.</p>
<p>Sheppard asked his audience to sit with him and explore themes of grief, Indigenous suicide, and the transitionary healing of Sorry Business in Australia. I hold my grief in my throat. Sheppard gently brings the body down from its hanging place caressing this dear and valued soul that has nowhere to go. Suffering from internal sickness, pervading darkness and deep-seated trauma, the weight of reality and history is too much to bear.</p>
<p>Sheppard tells us this body could so easily have been his.</p>
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<em>
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Read more:
<a href="https://theconversation.com/why-are-we-losing-so-many-indigenous-children-to-suicide-114284">Why are we losing so many Indigenous children to suicide?</a>
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<h2>Indigenous suicide is a national crisis</h2>
<p>In 2018, an Australian <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/MentalHealthServices/Report/c04">Senate enquiry heard</a> overwhelming evidence from mental health experts that:</p>
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<p>in too many cases, the causes of suicide for Aboriginal and Torres Strait Islander peoples is not mental illness, but despair caused by the history of dispossession combined with the social and economic conditions in which [they] live.</p>
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<p>Following the deaths of <a href="https://www.theguardian.com/australia-news/2019/mar/22/indigenous-suicide-35-dead-in-three-months-including-three-12-year-old-children">an alarming number Indigenous young people</a> earlier this year, Australian leaders were <a href="https://www.smh.com.au/healthcare/leaders-urged-to-declare-aboriginal-child-suicides-a-national-crisis-20190319-p515fh.html">urged to declare</a> a “national crisis”.</p>
<p>We know suicide is contagious. Within groups of vulnerable people, prior suicide can lead to the occurrence of others. <a href="https://www.lifeline.org.au/about-lifeline/lifeline-information/statistics-on-suicide-in-australia">Lifeline reports</a> the suicide rate amongst Indigenous people is more than double the national rate; Indigenous children die from suicide at <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30034-3/fulltext">five times the rate</a> of their non-Indigenous peers.</p>
<h2>Australia is not on track to ‘close the gap’</h2>
<p>The burden of suicide rests with our most disadvantaged. Its impact is mirrored in <a href="https://www.abc.net.au/news/2019-02-14/closing-the-gap-results-show-targets-off-track/10810602">findings</a> across child mortality, school attendance, life expectancy, reading and numeracy and employment. </p>
<p>Since 2005, Australia has endeavoured to “Close the Gap” with Indigenous people. Only early childhood education and year 12 attainment are on track to be met.</p>
<p>Mick Dodson, when he was Aboriginal and Torres Straight Islander Social Justice Commissioner, got to the heart of the issue in 1994 when he <a href="https://www.humanrights.gov.au/sites/default/files/content/social_justice/sj_report/sjreport05/pdf/SocialJustice2005.pdf">wrote</a>:</p>
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<p>The statistics of infant and perinatal mortality, are our babies and children who die in our arms… the statistics of shortened life expectancy, are our mothers and fathers, uncles, aunties and elders who live diminished lives and die before their gifts of knowledge and experience are passed on. We die silently under these statistics.</p>
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<p>As a clinical psychologist and 2018 WA Australian of the year, Dr Tracey Westerman has commented that, given we have one of the <a href="https://independentaustralia.net/life/life-display/australias-child-suicide-epidemic,11862">highest child suicide rates in the world</a>, it’s staggering we don’t have clear evidence of <a href="https://indigenousx.com.au/what-are-the-causes-of-indigenous-suicides/">causal relationships and casual pathways</a> to inform statistics of Indigenous suicide.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-despair-not-depression-thats-responsible-for-indigenous-suicide-108497">It's despair, not depression, that's responsible for Indigenous suicide</a>
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<h2>We need to acknowledge intergenerational trauma</h2>
<p>Both major political parties have announced their intention to commit funding to stop the Indigenous suicide epidemic. Prime Minister Scott Morrison has directed <a href="https://www.liberal.org.au/our-plan-youth-mental-health-and-suicide-prevention">$A503.1 million into a strategy</a> to fund research and services to boost the government’s youth mental health and suicide prevention plan.</p>
<p>During the election campaign, <a href="https://www.alp.org.au/media/1539/2018_alp_national_platform_constitution.pdf">Labor</a> promised effective urban and rural suicide prevention projects. </p>
<p>These commitments are, at least, something. But none of these policies acknowledge the need to educate non-Indigenous people about the complex narrative of Australia’s dispossession. Invasion, frontier violence and massacre exist within living memory of Indigenous families, as do slavery, stolen wages, mandatory sentencing, and myriad racist government policies across Australia that have contributed to harm – and continue to do so.</p>
<p>Given ongoing disadvantage, along with <a href="https://www.ccnsa-nccah.ca/docs/context/RPT-HistoricTrauma-IntergenTransmission-Aguiar-Halseth-EN.pdf">emerging evidence</a> that the effects of <a href="https://indigenousx.com.au/what-are-the-causes-of-indigenous-suicides/">trauma</a> can be passed on from one generation to another, for Indigenous people, in a real sense, our “history” rests in our body. Its effect is inescapable, we do not have a choice, we do not get to decide whether intergenerational trauma affects us or not.</p>
<p>The prime minister has called his $A6.7 million plan to retrace Captain Cook’s circumnavigation of Australia a “great opportunity to talk about our history”, even though Cook’s voyage only went along the east coast.</p>
<p>This is just a small example of the widespread casual ignorance about our colonial past that means most Australians wouldn’t be able to connect the dots between <a href="https://www.sbs.com.au/nitv/article/2019/03/11/one-nation-aboriginal-indigenous-dna">One Nation’s proposed system of Indigenous identification</a> – requiring me and my kids to undergo DNA testing to prove 25% ancestry – and the Stolen Generation strategy to breed out the colour.</p>
<p>This ignorance, and the continued discriminatory behaviour towards Indigenous peoples, prevents meaningful, ongoing action.</p>
<p>There is no empathy for the impact of history on Indigenous people in Australia. Our history is not an open book. I only need to mention Australia Day to make my point. We are yet to come to terms with our entangled history, our story and how to begin a process of truth-telling.</p>
<p>Policies aimed at reducing Indigenous youth suicide will fail to achieve their aims if they don’t fully acknowledge the cumulative effects of our history, associated intergenerational trauma and the ongoing violence towards Indigenous Australians.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/indigenous-voices-are-speaking-loudly-on-social-media-but-racism-endures-94287">Indigenous voices are speaking loudly on social media but racism endures</a>
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<h2>Australia must change</h2>
<p>The violence of dispossession is spilling across generations and has become a disease that is destroying our families and communities. It is not safe to be an Indigenous person in Australia. Where can we have a frank and brave conversation about this? </p>
<p>I watch the stage as Sheppard tucks his people in to dream without ceremony, dance or song. Without the safety of cultural authority and the healing transition of Sorry Business, our people move with Sheppard through grief to despair to madness to silence. What else is there to do but sit quietly with him and begin to speak back for the dead?</p>
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<p><em>If you or anyone you know needs help or support, you can call <a href="http://www.lifeline.org.au/">Lifeline </a>on 13 11 14.</em></p>
<p><em>This is an edited version of an article co-published with <a href="https://pursuit.unimelb.edu.au/">Pursuit</a>.</em></p><img src="https://counter.theconversation.com/content/117261/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julia Hurst does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Policies aimed at reducing youth suicide will fail if they don’t acknowledge the cumulative effects of history, associated intergenerational trauma and ongoing violence towards Indigenous Australians.Julia Hurst, Faculty of Arts Indigenous Postdoctoral Fellow, Indigenous and Settler Relations Collaboration, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1142842019-03-29T06:29:16Z2019-03-29T06:29:16ZWhy are we losing so many Indigenous children to suicide?<figure><img src="https://images.theconversation.com/files/266238/original/file-20190328-139377-3badvp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Over the past five years, one in every four children who died by suicide in Australia was Indigenous.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com">Shutterstock</a></span></figcaption></figure><p><em>This article was written with Rob McPhee, Deputy CEO of the Kimberley Aboriginal Medical Service and co-chair of the Commonwealth-funded Kimberley Aboriginal Suicide Prevention Working Group</em>.</p>
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<p>The <a href="https://www.smh.com.au/healthcare/leaders-urged-to-declare-aboriginal-child-suicides-a-national-crisis-20190319-p515fh.html">recent child and youth suicides</a> in our communities are a tragedy. Five young Indigenous Queenslanders have <a href="https://www.theaustralian.com.au/nation/suicide-now-normal-for-indigenous-youth/news-story/d821f8f367245a9b3ad95928a1cf76ea">taken their lives</a> this month. This adds to a <a href="https://www.news.com.au/national/five-indigenous-girls-take-their-own-lives-in-nineday-period/news-story/f800a3e6ebc210e37cb3084854381fdf">spate of child deaths</a> in Adelaide and Western Australia in January.</p>
<p>There is nothing new about Indigenous child suicide. In 2017 it was the <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2017%7EMain%20Features%7EIntentional%20self-harm%20in%20Aboriginal%20and%20Torres%20Strait%20Islander%20people%7E10">leading cause of death</a> among our children aged 5 to 17. Aboriginal and Torres Strait Islander people account for just 2.8% of the population, but over the past five years, one in every four Australian children who died by suicide was Indigenous. </p>
<p>There is something especially shocking about the suicide of a child for whom life was just beginning. It indicates serious underlying issues in our society, and <a href="http://atsichsbrisbane.org.au/wp-content/uploads/2010/09/Indigenous-childrens-issues-0203.pdf">our children are reacting to</a> their environment. We need to <a href="http://www.indigenous.uwa.edu.au/indigenous-research/Centre-for-Best-Practice">act now</a> to prevent as many potential child suicides as possible in our communities. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/indigenous-suicide-rates-in-the-kimberley-seven-times-national-average-61502">Indigenous suicide rates in the Kimberley seven times national average</a>
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<h2>Tackle both short- and long-term change</h2>
<p>Short- and long-term action is essential, but alongside this, long-term action must begin to address the traumatic, disrupting and intergenerational effects of colonisation and its aftermath: poverty and social exclusion. These are <a href="https://www.atsispep.sis.uwa.edu.au/__data/assets/pdf_file/0006/2947299/ATSISPEP-Report-Final-Web.pdf">deep-rooted contributors</a> to Indigenous suicide and child suicide. </p>
<p>Children <a href="https://www.atsispep.sis.uwa.edu.au/__data/assets/pdf_file/0006/2947299/ATSISPEP-Report-Final-Web.pdf">may be at higher risk</a> of suicide if they experience behavioural and emotional challenges, bullying, family and relationship breakdown, and issues that contribute to other forms of psychological distress.</p>
<p>In the short term, we need to identify and provide immediate help to our children and young people in crisis situations. Families, peers and schools need to be involved, with backup from counsellors and, if required, 24/7 access to culturally competent mental health professionals. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-despair-not-depression-thats-responsible-for-indigenous-suicide-108497">It's despair, not depression, that's responsible for Indigenous suicide</a>
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</em>
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<p>Some child and young person suicides occur in “clusters”, where several deaths occur over a short period in the same place.</p>
<p>Ensuring children and young people exposed to family and community suicide receive “postvention” support can <a href="https://thirrili.com.au/nicrs/">also be vital</a> to preventing further suicides. Postvention is an intervention after a death to provide counselling, material support, and other assistance to the family and community of the deceased.</p>
<p>To avoid imitations, responsible, non-sensational <a href="https://mindframe.org.au/">media and social media discussion about suicide</a> is crucial. Proactively monitoring the social media activity of children for signs of suicidal thoughts can also <a href="https://natsilmh.org.au/sites/default/files/Final%20Brisbane%20workshop%20report.pdf">play a role</a> in preventing suicide in a community.</p>
<p>In the medium term, communities <a href="https://www.atsispep.sis.uwa.edu.au/">must be empowered</a> to co-design and control responses that capitalise on the community’s strengths. </p>
<p>We can also learn from <a href="https://www.atsispep.sis.uwa.edu.au/__data/assets/pdf_file/0006/2947299/ATSISPEP-Report-Final-Web.pdf">past programs</a> that have been evaluated and shown to be successful in preventing Indigenous child and youth suicide. This includes <a href="https://www.atsispep.sis.uwa.edu.au/__data/assets/pdf_file/0006/2947299/ATSISPEP-Report-Final-Web.pdf">peer-to-peer mentoring networks</a>; programs to engage children and young people, including in sport; and connecting young people to Elders and culture.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/d415CdeNemM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Culture is Life backs Aboriginal-led solutions that deepen connection and belonging to culture and country and supports young Aboriginal and Torres Strait Islander people to thrive.</span></figcaption>
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<h2>Blueprint for action</h2>
<p>In November 2018, two Indigenous suicide prevention conferences in Perth brought together 500 delegates from the national and international Indigenous communities to identify solutions that work in Indigenous suicide prevention.</p>
<p>The delegates called for a <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pub-atsi-suicide-prevention-strategy">new national Aboriginal and Torres Strait Islander suicide prevention strategy</a> – and fully funded implementation plan – with a focus on preventing child and youth suicide. </p>
<p>This should build on the <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pub-atsi-suicide-prevention-strategy">2013 strategy</a>, adapted to the current policy environment, with an increased focus on suicide prevention. </p>
<p>The plan should also address stopping, and otherwise healing, child sexual abuse that is <a href="https://www.sciencedaily.com/releases/2019/01/190109192533.htm">increasingly associated with suicide</a>.</p>
<p>It’s important the plan is developed in genuine partnership with our communities, suicide prevention experts and mental health leaders. It should: </p>
<ul>
<li>support Indigenous community empowerment and self-determination</li>
<li>enable suicide prevention programs to be co-designed with Indigenous communities</li>
<li>focus on increasing the Indigenous suicide prevention workforce to levels that meet demand</li>
<li>ensure the workforce is culturally safe and competent</li>
<li>embed (and appropriately remunerate) youth peer workers, Elders and cultural healers in mental health and suicide prevention services</li>
<li>include a plan to build the evidence-base for, and fund, Indigenous suicide prevention research. </li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/well-connected-indigenous-kids-keen-to-tap-new-ways-to-save-lives-30964">Well-connected Indigenous kids keen to tap new ways to save lives</a>
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<h2>Truth and healing to move forward</h2>
<p>Any sustainable response must go to the deeper, underlying historical causes of hopelessness and despair, which contributes to suicide. This isn’t just a problem among children; the <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2017%7EMain%20Features%7EIntentional%20self-harm%20in%20Aboriginal%20and%20Torres%20Strait%20Islander%20people%7E10">suicide rate peaks</a> in those aged between 25 and 34.</p>
<p>These deeper causes include intergenerational trauma. Poverty, racism, social exclusion, substandard housing, and economic marginalisation of our communities are the legacies of colonisation. </p>
<p>Indigenous suicide is different because it cannot be separated from the historical and related present-day situation of our peoples. Indigenous people from around the world share both similar histories and high rates of child, youth and other suicide.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=407&fit=crop&dpr=1 600w, https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=407&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=407&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=512&fit=crop&dpr=1 754w, https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=512&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/266261/original/file-20190328-139371-veh6wm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=512&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Acknowledging the truth allows people to start healing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1133622494?size=huge_jpg">Annie 888/Shutterstock</a></span>
</figcaption>
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<p>Indigenous leaders want to see a broader Australian recovery and healing. Truth is the basis for healing and moving forward. And this process can begin by recognising the impacts of colonisation on present-day trauma, disadvantage, marginalisation, and neglect. </p>
<p>Some Elders have suggested a royal commission or “truth and reconciliation commission” could form the foundation for this process. </p>
<p>Our communities and cultures are sources of identity, values and practices that can help protect against suicide. Such strengths provide the foundation for a mix of short, medium, and longer-term action to turn the trajectory of Indigenous child and youth suicide deaths around.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/reducing-indigenous-suicide-through-empowerment-and-pride-7760">Reducing Indigenous suicide through empowerment and pride</a>
</strong>
</em>
</p>
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<p><em>If you or anyone you know needs help or is having suicidal thoughts, contact <a href="https://www.lifeline.org.au/">Lifeline</a> on 131 114 or <a href="https://www.beyondblue.org.au/">beyondblue</a> on 1300 22 46 36.</em></p><img src="https://counter.theconversation.com/content/114284/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tanja Hirvonen serves as the Executive Support Officer for the Australian Indigenous Psychologists Association. Tanja provides supervision for the NICRS team.</span></em></p><p class="fine-print"><em><span>Pat Dudgeon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Poverty and social exclusion play a big role in Indigenous child suicide. The causes are complex but we know enough to act now to reduce the number of deaths in our communities.Pat Dudgeon, Professor, The Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, the Poche Centre for Indigenous Health, The University of Western AustraliaTanja Hirvonen, Lecturer in Mental Health, Centre for Remote Health, Flinders UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/825852017-08-23T19:30:29Z2017-08-23T19:30:29ZExpansion of cashless welfare card shows shock tactics speak louder than evidence<figure><img src="https://images.theconversation.com/files/182717/original/file-20170821-17116-1j4rnqe.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Minderoo Foundation's video was a heavy-handed illustration of problems in some WA communities.</span> <span class="attribution"><a class="source" href="https://vimeo.com/228824624/8ba17856b5">Screenshot/Minderoo Foundation</a></span></figcaption></figure><p>The federal government last week <a href="http://www.abc.net.au/news/2017-08-18/cashless-card-advocate-defends-scheme-in-court-wa/8821252">passed legislation</a> to expand the trial of the <a href="https://www.dss.gov.au/families-and-children/programmes-services/welfare-conditionality/cashless-debit-card-overview">cashless welfare card</a> to other areas of Australia. The <a href="https://www.facebook.com/groups/1486363324991953/">controversial</a> policy quarantines 80% of welfare payments to Indigenous Australians living in the Ceduna and East Kimberley regions of Western Australia and cannot be used on gambling, alcohol or to withdraw cash.</p>
<p>The passing of the legislation comes as an inquest into 13 Aboriginal youth suicides in the Kimberley region is <a href="http://www.abc.net.au/news/2017-08-14/suicide-inquest-hears-concern-over-cashless-welfare-cards/8805774">hearing about the welfare card’s</a> impact. It’s also a few weeks after mining billionaire Andrew Forrest’s philanthropic organisation, the <a href="https://www.minderoo.com.au/philanthropy/">Minderoo Foundation</a>, together with regional councils and outgoing WA Police Commissioner, Karl O'Callaghan, were conveyed to Canberra to advocate for the card’s expansion. </p>
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<p>The lobbying <a href="https://vimeo.com/228824624/8ba17856b5">came in a video</a> designed to shock with emotive descriptions of child abuse and footage of children lifted by their hair and stomped on. It implied a strong link between violence against children and income management. Forrest and his supporters were strategic in <a href="http://www.abc.net.au/news/2017-04-22/andrew-twiggy-forrest-pushes-for-expansion-of-centrelink-cdc/8463006">promoting</a> income management and showing <a href="http://www.abc.net.au/news/2017-08-09/andrew-forrest-uses-violent-video-to-push-cashless-welfare-card/8789616">their video</a> before appealing their case to the Prime Minister.</p>
<p>While we can’t necessarily attribute the trial’s expansion to the success of the campaign, it shows evidence-based approaches, which speak against continuing the policy, have been ignored. This is another case that adds to <a href="http://blogs.lse.ac.uk/lsereviewofbooks/2014/02/07/book-review-beyond-evidence-based-policy-in-public-health-the-interplay-of-ideas-by-katherine-smith/">growing concern</a> among researchers that evidence-based policy formulation is being <a href="https://theconversation.com/who-are-you-calling-anti-science-how-science-serves-social-and-political-agendas-74755">threatened</a> by easily-digestible, emotive campaigns.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-cashless-debit-card-causes-social-and-economic-harm-so-why-trial-it-again-74985">The Cashless Debit Card causes social and economic harm – so why trial it again?</a>
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</em>
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<h2>Does income management work?</h2>
<p>The Minderoo Foundation and some community members promote the <a href="https://www.dss.gov.au/families-and-children/programmes-services/welfare-conditionality/cashless-debit-card-overview">cashless debit card</a> as it cannot be used to buy alcohol, gambling products or to withdraw cash. While not a panacea, they believe it will be a <a href="http://www.skynews.com.au/news/national/wa/2017/08/09/leaders-plead-for-welfare-card-rollout.html">potential circuit breaker</a> as it “… gives community services a chance, that gives health workers a chance, that gives the police a chance”. </p>
<p>The government has long been using income management as a <a href="https://www.dss.gov.au/our-responsibilities/families-and-children/publications-articles/income-management-fact-sheets/child-protection-measure-of-income-management">child protection tool</a>. Yet there is little evidence to suggest income management policies improve children’s well-being. </p>
<p>An <a href="https://aifs.gov.au/publications/family-matters/issue-97/welfare-conditionality-child-protection-tool">evaluation of income management</a> in the NT in 2014 found people subjected to child protection income management made up a small proportion (0.5%) of the overall income management population. So evaluating whether the policies worked was difficult. Instead researchers relied on interviews with child protection staff which were varied. </p>
<p>Meanwhile, the <a href="https://childdetentionnt.royalcommission.gov.au/Search/Results.aspx?k=silburn">Royal Commission</a> into the Protection and Detention of Children in the NT has heard that child protection notifications, substantiations of these, as well as out-of-home placements had all more than doubled since 2007.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/more-income-management-trials-will-prove-futile-it-doesnt-work-46334">More income management trials will prove futile – it doesn't work</a>
</strong>
</em>
</p>
<hr>
<p>If the card’s aim is to reduce alcohol-fuelled violence in general, the evidence is again unconvincing. The NT evaluation above revealed no statistically
significant changes in the level of reported problems for either those on compulsory or voluntary income management. But it did show the direction of change was towards a relative worsening of problems due to drinking.</p>
<h2>Social determinants</h2>
<p>Dr <a href="http://www.smh.com.au/wa-news/oppressive-scheme-wa-youth-suicide-inquest-slams-cashless-welfare-card-20170814-gxw7f9.html">Elise Klein,</a> who is researching the cashless welfare card, told the inquest into the suicide of Indigenous youths it is an “oppressive scheme” representing neocolonialism and government overreach. </p>
<p>Indeed, the government has a long history of restricting an individual’s choices supposedly in their best interest. One example is the <a href="https://www.legislation.nsw.gov.au/acts/1902-47.pdf">Aborigines Act 1902</a>, which resulted in a Chief Protector who was “the legal guardian of every aboriginal and half-caste child to the age of 16 years”.</p>
<p>Colonisation’s <a href="https://link.springer.com/article/10.1007/s40653-016-0117-9">damaging effects</a> across generations is an issue shared globally by most Indigenous people. The suggested reparation work is the first step in tackling the social determinants of health which are many including education, employment and income, with education being <a href="https://www.mja.com.au/journal/2017/207/1/improving-indigenous-health-through-education">the most potent</a>. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/social-determinants-how-class-and-wealth-affect-our-health-64442">Social determinants – how class and wealth affect our health</a>
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</em>
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<p>The next step is to tackle the <a href="https://www.mja.com.au/system/files/issues/194_10_160511/mar10460_fm.pdf">causes of the causes</a>, which will <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-016-0085-4">only occur</a> if there is support from the highest political levels. In the absence of this, <a href="https://croakey.org/whose-problem-is-it-anyway-transforming-the-public-health-narrative-to-stem-the-tide-of-lifestyle-drift/">lifestyle drift</a> <a href="http://www.tandfonline.com/doi/abs/10.1080/09581596.2010.520692">thrives</a> whereby policy initiatives to tackle inequalities in health that begin with a broad social determinants approach drift down in favour of blaming individuals for becoming sick as a result of their poor <a href="https://theconversation.com/dont-be-surprised-by-abbotts-comments-about-lifestyle-choices-38711">lifestyle choices</a>. </p>
<p>It is easier for governments to support <a href="http://www.tandfonline.com/doi/abs/10.1080/09581596.2010.520692">healthy lifestyle</a> promotion programs despite the risk that sometimes these approaches are <a href="https://www.ncbi.nlm.nih.gov/pubmed/12380855">ineffective and even counterproductive</a>. In addition they can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423493/">increase inequality</a>. </p>
<h2>A spray-on solution</h2>
<p>With the <a href="http://www.nusap.net/spe/mackenbach_strategy%20failure_ssm%202010.pdf">perception</a> that truly addressing the <a href="http://www.who.int/social_determinants/resources/csdh_media/baum_iuhpe_07.pdf">social determinants of health</a> is too hard, it is understandable why the cashless welfare card is attractive. It is easier to <a href="https://academic.oup.com/cdj/article-abstract/doi/10.1093/cdj/bsx008/3572908/Community-as-a-spray-on-solution-a-case-study-of?redirectedFrom=fulltext">spray-on</a> a solution rather taking responsibility for tackling underlying <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-1087">public health and social policy issues</a>. However, taking the easier option is a <a href="http://www.tandfonline.com/doi/full/10.1080/09581596.2016.1184229?src=recsys">health risk</a>. </p>
<p>The principle of “<a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)63069-3/fulltext">let the data do the talking</a>” to influence government polices is failing. Data can be hard to access requiring <a href="https://www.crikey.com.au/2017/08/14/rundle-forrest-forces-the-issue-on-cashless-welfare-card/">subscriptions</a> or <a href="http://www.tandfonline.com/doi/full/10.1080/0312407X.2012.708763?scroll=top&needAccess=true">payment</a>, whereas news of the Forrest campaign was readily accessible. The message was also straightforward, while researchers don’t have a well resourced foundation to assist with conveying complex concepts. </p>
<p>Researchers are rarely as <a href="https://www.forbes.com/profile/andrew-forrest/">high profile</a> with <a href="http://www.abc.net.au/news/2017-05-22/andrew-twiggy-forrests-history-of-grand-goals-and-grand-gestures/8548134">political influence</a> and are <a href="https://theconversation.com/government-buries-its-own-research-and-thats-bad-for-democracy-60488">vulnerable</a> to having their research buried. This experience reveals the need for <a href="https://theconversation.com/academics-cant-change-the-world-when-theyre-distrusted-and-discredited-77420">academics and scientists</a> to <a href="https://www.ncbi.nlm.nih.gov/pubmed/25616195">better understand the policy process</a>, to step up and be more <a href="http://www.bmj.com/content/350/bmj.h81">political</a> and <a href="https://global.oup.com/academic/product/health-inequalities-9780198703358?cc=us&lang=en&">actively involved in advocacy</a>. Forrest et al have provided a lesson on how to do it.</p>
<hr>
<p><strong><em>Read more: <a href="https://theconversation.com/why-politicians-think-they-know-better-than-scientists-and-why-thats-so-dangerous-72548">Why politicians think they know better than scientists – and why that’s so dangerous</a></em></strong></p><img src="https://counter.theconversation.com/content/82585/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Bret Hart is affiliated with the Social Determinants of Health Alliance as chair and is an Independent Board Director of Puntukurnu Aboriginal Medical Service and deputy chair of the Board of Wellbeing in Schools Australia.</span></em></p>The trial of the cashless welfare card, to control unhealthy spending in Indigenous communities, is being expanded partly due to emotive well-funded campaigns. Meanwhile, evidence is being ignored.Michael Bret Hart, Adjunct Clinical Associate Professor Curtin Medical School Public Health Physician, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/686732016-11-14T02:50:43Z2016-11-14T02:50:43ZPlan to reduce Indigenous suicides finally acknowledges lack of evidence and need for hope<p>Last week the government released the <a href="http://www.dpmc.gov.au/resource-centre/indigenous-affairs/solutions-work-what-evidence-and-our-people-tell-us">Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project</a> report, which gave recommendations to reduce the high rate of suicide among Aboriginal and Torres Strait Islander people.</p>
<p>Minister for Indigenous affairs Nigel Scullion said the government welcomed the report with a very <a href="https://ministers.dpmc.gov.au/scullion/2016/community-led-solutions-indigenous-suicide-prevention">heavy heart</a>. And it is with a heavy heart I write this response.</p>
<p>There are many factors contributing to Indigenous suicide, occurring in a wide variety of contexts. This combination creates a major challenge for the report’s authors, who are to be commended for tackling what is one of the most tragic crises of our time. </p>
<p>No document can answer every question on Indigenous suicide, and this report doesn’t presume to do so. It does recognise that no two Indigenous suicides are identical, then skilfully identifies common themes for informing responses that have the potential to save lives.</p>
<h2>The report’s recommendations</h2>
<p>The authors acknowledge there is surprisingly little evidence about what works for Indigenous-specific suicide prevention; hence their mandate to write the report. In a sense, given this lack of an evidence base, they are trailblazers. This report has the potential to be the catalyst for positive change for Indigenous Australians.</p>
<p>First, the report’s authors note the association <a href="http://www.smh.com.au/comment/stop-the-blame-game-and-get-real-about-fixing-aboriginal-communities-20160313-gnhqaf">between sexual abuse and increased risk of suicide</a>. This is something many are reluctant to do, but this <a href="https://aifs.gov.au/cfca/publications/long-term-effects-child-sexual-abuse/impact-child-sexual-abuse-mental-health">association</a> is one piece of the puzzle that must be discussed. The report notes rates of sexual abuse are high in out-of-home care such as orphanages and foster homes, and this disproportionately affects Indigenous children. Measures need to be taken to prevent sexual abuse – whether it be in the community or in out-of-home care.</p>
<p>Second, recognising the great diversity among Indigenous Australians, the report provides recommendations flexible enough to be readily adapted for local implementation. For example, the report emphasises the need for community-led programs (recommendation 2), as well as the significant role of Aboriginal Community Controlled Health Services (recommendation 10).</p>
<p>Third, while there will always be a need for crisis intervention for suicide, it is reassuring the authors frequently mention “upstream approaches” which include improving such social determinants of health as sense of belonging, stability, and hope. Prevention is the best cure for suicide.</p>
<h2>Employment is an important factor, too</h2>
<p>Though not covered comprehensively in the report, upstream approaches should be extended to include employment. Suicide results from feeling hopeless and helpless, and employment plays a significant role in restoring hope and creating opportunities for a meaningful life. When adults are employed, communities are more vibrant. The importance of jobs cannot be over emphasised. </p>
<p>A significant contributor to the report, Gerry Georgatos, <a href="http://www.abc.net.au/news/2016-01-18/suicide-prevention-funding-for-wa-critical-response/7093006">said</a>:</p>
<blockquote>
<p>We have to restore hope. And to restore hope, we have to actually create opportunity for people in these communities.</p>
</blockquote>
<p>Indigenous politician, Alison Anderson, <a href="http://www.alicespringsnews.com.au/2012/11/03/indigenous-adults-must-grow-up-so-that-indigenous-children-can-depend-on-them-says-alison-anderson/">says about jobs</a>: </p>
<blockquote>
<p>It is not just about the money […] It is about status and respect, about responsibility and dignity.</p>
</blockquote>
<p>Having a job is more than just an income – it contributes greatly towards meeting fundamental human needs and <a href="http://caepr.anu.edu.au/sites/default/files/Publications/topical/Topical_Issue_01-2014_GrayHunterBiddle_EconomicSocialBenefitsIndigenousEmployment.pdf">attaining sound mental health</a>.</p>
<p>A major challenge in combating suicide is how to respond to those locations, often remote communities, where employment opportunities are limited or even non-existent. Where unemployment rates are high, there is emotional pain, and suicide can be seen as the only solution.</p>
<h2>Creating a narrative of empowerment</h2>
<p>The report stresses the need to “acknowledge and understand the devastating and enduring impact of the colonial legacy on Indigenous people’s contemporary lives”. While it’s fine to acknowledge historical injustices, it’s disempowering to let this form the overarching narrative of our lives. </p>
<p>I have argued elsewhere <a href="https://quadrant.org.au/opinion/bennelong-papers/2015/07/hobbled-history-immersed-self-pity/">we’re not victims of the past, but victims of our view of the past</a>. Let’s celebrate Indigenous success to create a positive and empowering narrative of our Indigenous people. </p>
<p>There are countless successful Indigenous people such as Bess Price, Stan Grant, and Marcia Langton, as well as the Indigenous contributors of the report, who provide proof the legacy of colonisation doesn’t need to hold people back. </p>
<p>Finally, the report mentions culture. For example, it says Indigenous culture should be taught in schools. Cultural appropriateness is important in some instances, but to reduce suicide and improve overall health, Indigenous Australians need a worldview that helps them access modern services, clean water, fresh food, quality education and most importantly, opportunity to contribute to the well-being of others.</p>
<p>Ultimately, Indigenous Australians need real access to the opportunities other Australians take for granted. The recommendations in this report can help Indigenous Australians attain those opportunities.</p><img src="https://counter.theconversation.com/content/68673/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anthony Dillon receives funding from The Australian Research Council. </span></em></p>A new report recognises that no two Indigenous suicides are identical, then skilfully identifies common themes for informing responses that have the potential to save lives.Anthony Dillon, Lecturer, Faculty of Health Sciences, Australian Catholic UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/615022016-06-26T20:00:04Z2016-06-26T20:00:04ZIndigenous suicide rates in the Kimberley seven times national average<p><a href="https://www.mja.com.au/">Results of a new audit</a> tell a tale that is, sadly, all-too-familiar across the Top End of Australia. Rates of Indigenous suicide in the Kimberley region over the last ten years were seven times the national average. </p>
<p>While the national rate is about <a href="http://www.mindframe-media.info/for-media/reporting-suicide/facts-and-stats">12 people dying by suicide for every 100,000</a> people, rates in the Kimberley region were 74 people per 100,000. We also found the rate of suicidality (people talking about or threatening to suicide) among Indigenous populations in this region was about ten times that of the general population in Australia.</p>
<p>This ever-rising tide helps confirm that two worlds, with widely differing experiences of life (and death), are living in this country. </p>
<h2>Effects of colonisation</h2>
<p>This is not “news”. The scenario of such widely differing rates of suicide between Indigenous and non-Indigenous peoples living in colonised countries has been <a href="http://spjp.massey.ac.nz/books/bolitho/Chapter_3.pdf">well documented around the globe</a> including in North America, New Zealand and the Pacific Islands.</p>
<p>Indigenous suicide may be considered one of the “downstream” effects of the processes involved in colonisation, followed by further cultural disruption in the wake of efforts to decolonise. </p>
<p>In many ways it is difficult to disentangle Indigenous suicide causally from so many other related calamities – increased exposure to domestic violence, childhood trauma and sexual abuse, and the ravages of alcohol, and now, ice abuse.</p>
<p>In marked contrast, prior to colonisation and all that came with it, suicide <a href="http://www.nt.gov.au/lant/parliamentary-business/committees/ctc/youth-suicides/Submissions/Sub%20No.%2008,%20Robert%20Parker,%20Top%20End%20Mental%20Health,%20Part%202,%2029%20Sept%202011.pdf">appears to have been unknown</a> in traditional Indigenous society.</p>
<p>Indigenous suicide <a href="http://www.ncbi.nlm.nih.gov/pubmed/16574613">has been characterised as</a> one potential outcome of an intergenerational transmission of mass trauma – including massacres, being pushed off traditional lands, policy resulting in the loss of parent/child attachments (Stolen Generations), social inequality and institutionalised racism. </p>
<p>The custodial system was one setting in which Indigenous suicide emerged – a population in which Indigenous Australians continue to be <a href="https://theconversation.com/indigenous-incarceration-in-australia-at-a-glance-57821">vastly overrepresented</a>. In the spotlight of extensive media coverage of the <a href="http://www.naa.gov.au/collection/fact-sheets/fs112.aspx">Royal Commission into Aboriginal Deaths in Custody</a>, awareness of Indigenous suicide was migrating into the c ycommunity in the 1990s, and in the ensuing decades the rates have soared.</p>
<p>Our data confirms the most at risk group are Indigenous youth, and as if this was not worrying enough, <a href="http://www.news.com.au/national/western-australia/calls-for-nation-action-after-girl-10-commits-suicide/news-story/5e7977e6a128d7916b5f309ec92b8be8">now children are also at risk</a>. </p>
<p>We know world-wide those transitioning into adulthood <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885157/">appear at increased risk</a>. In our study we found 68% of those who suicided were under 30 years old, and 27% were under 20. And although originally predominately affecting males, female Indigenous youth suicide and suicidality are now increasing.</p>
<h2>Is there a solution?</h2>
<p>Elevated Indigenous suicide rates may be seen as perhaps the most poignant marker of the additional psychological and physical burden many in the contemporary Australian Indigenous population, especially in a rural and remote setting such as the Kimberley, face. </p>
<p>But tragic though these rates are, they are just the tip of the iceberg. </p>
<p>As we widen out our field of view, we encounter suicidality behaviours (such as self harm) at rates of ten times those experienced by the non-Indigenous population, Indigenous <a href="https://theconversation.com/indigenous-incarceration-in-australia-at-a-glance-57821">incarceration rates</a> at 2,253 people in 100,000 compared to 146 in 100,000 in the non-Indigenous population, severe housing problems including overcrowding, more infectious disease, more chronic disease, and a lifespan that is <a href="http://www.aihw.gov.au/deaths/life-expectancy/">ten years lower</a> than the non-Indigenous population.</p>
<p>The situation our findings attest to is not unique to the Kimberley, or for that matter Australia.</p>
<p>As we look for solutions it is clear well-intentioned organisations and individuals throughout the colonised world have been searching for a good answer for a long time. </p>
<p>Finding a way to fix the problems that lead to Indigenous suicide has proved to be a complicated issue without a simple, incisive, short-term solution.</p>
<p>We have to find a new way, led by true cultural respect and partnership, evidence, and long-term commitments to empower and instil hope into each Indigenous generation as it emerges, if we are to gradually turn the tide.</p>
<hr>
<p><em>If this article has raised issues for you or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/61502/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Murray Chapman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Results of a new audit tell a tale that is, sadly, all-too-familiar across the Top End of Australia.Murray Chapman, Associate Professor, School of Psychiatry and Clinical Neurosciences, The University of Western AustraliaLicensed as Creative Commons – attribution, no derivatives.