Supporting the social and emotional wellbeing of Aboriginal and Torres Strait Islander Victorians

Many Victorian Aboriginal people and their communities are strong and rich in their culture. However, Aboriginal people generally experience significantly poorer mental health, wellbeing and safety outcomes than non-Aboriginal people. The legacy of trans-generational trauma and experiences of systemic racism and discrimination are key drivers of these poorer outcomes.

This is a significant time for Aboriginal communities in Victoria and the Victorian Government. The Victorian Government is committed to supporting Aboriginal self- determination as the overarching policy and implementation driver to improve Aboriginal health, wellbeing and safety; while also working towards Treaty with Victorian Aboriginal communities.

Balit Murrup: social and emotional wellbeing framework 2017-2027 embeds Aboriginal self-determination as the core principle to drive actions to improve the social and emotional wellbeing, resilience and mental health of Aboriginal people, families and communities.

Balit Murrup is a key commitment under Victoria's 10 Year Mental Health Plan and was developed alongside Korin Korin Balit-Djak: Aboriginal health, wellbeing and safety strategic plan 2017-2027 -- the overarching framework for action to improve the health, wellbeing and safety of Aboriginal Victorians now and over the next 10 years.

Balit Murrup has been developed with the shared knowledge and wisdom of leaders and experts in Aboriginal social and emotional wellbeing and mental illness. Balit Murrup also aligns with the National Gayaa Dhuwi (Proud Spirit) Declaration which sets out the principles for governments, professional bodies and services to support Aboriginal and Torres Strait Islander leadership across all parts of the Australian mental health system. Gayaa Dhuwi aims to achieve the highest attainable standard to mental health and suicide prevention outcomes for Aboriginal and Torres Strait Islander peoples.

Balit Murrup: Domains for action

Domain 1: Improving access to culturally responsive services

• Strengthening access to culturally responsive social and emotional wellbeing and mental health services.
• More Aboriginal people accessing culturally appropriate treatment and care.

Domain 2: Supporting resilience, healing and trauma recovery

• Aboriginal-led health promotion and prevention initiatives.
• Recognition of the integral importance of traditional and contemporary healing approaches.
• Promotion of trauma-informed services models and clinical practice.

Domain 3: Building a strong, skilled and supported workforce

• New Aboriginal social and emotional wellbeing and mental health workforce training program.
• Expansion of Aboriginal social and emotional wellbeing, mental health and alcohol and drug workforce in Aboriginal and mainstream services.
• Supporting new multi-disciplinary social and emotional wellbeing teams.

Domain 4: Integrated and seamless service delivery

• Exploration of new service models and integrated continuity of care.
• Promotion of partnerships for prevention and recovery.

New investments supporting Balit Murrup

New investments have been made to ensure that the strategic priorities linked across each of the four Balit Murrup domains are translated into practical actions that will make a tangible difference to the social and emotional wellbeing outcomes of Aboriginal people.

Improving mental health outcomes for Aboriginal and Torres Strait Islander People with moderate to severe mental illness (Demonstration Projects) initiative

To improve access to culturally responsive services, the Victorian Government allocated $20.2 million ($7.7 million in 2016-17, $4 million in 2018-19 and $8.5 million in 2019-20) for four consortia demonstration projects to test new service models for Aboriginal Victorians with moderate to severe mental illness, trauma and other complex health and social needs.

The four demonstration projects are delivering integrated, culturally safe mental health services that are designed to meet the mental health, and social and emotional wellbeing needs of their local Aboriginal communities.

Each consortium is led by an Aboriginal Community Controlled Organisations in partnership with a local public health service.

The four demonstration sites are:

• Ballarat and District Aboriginal Co-operative (in partnership with Ballarat Health)
• Mallee District Aboriginal Services (in partnership with Mildura Base Hospital and Mallee Family Care)
• Victorian Aboriginal Health Service (in partnership with St Vincent Health, Austin Health, Northern Area Mental Health)
• Wathaurong Aboriginal Co-operative (in partnership with Barwon Health).

The partnership models encourage coordination of care with other service providers to deliver integrated wrap-around care for Aboriginal and Torres Strait Islander people with moderate to severe mental illness and other complex health and social support needs.

Expanded mental health workforce

The 2017-18 Victorian Government Budget committed $8.4 million (over three years) to support two new initiatives:

• A mental health traineeship program for Aboriginal people working in public mental health services ($3.5million).
• Aboriginal clinical and therapeutic positions in Aboriginal community-controlled health services ($4.9 million).

Aboriginal mental health traineeship program

The Aboriginal Mental Health Traineeship program is a new workforce strategy that will build a mental health workforce that can provide culturally safe and inclusive mental health care for Aboriginal Victorians.

10 Aboriginal Mental Health Trainees are employed by an Area Mental Health Service and provided with supervised workplace training and clinical placements over three years, while concurrently completing a Bachelor of Science (Aboriginal Mental Health) degree (distance study mode) though Charles Sturt University, NSW.

This specialist course aims to prepare trainees to work within mental health services with all Aboriginal and non-Aboriginal members of the community.

Trainees will work within a supportive and multidisciplinary team, working alongside other health professionals, both Aboriginal and non-Aboriginal.

Aboriginal knowledge and experience are critical to reforming mainstream mental health services to better understand the needs and aspirations of Aboriginal people while also ensuring practices are culturally safe. Without placing a burden on trainees, mental health services will respectfully learn from trainees about their own Aboriginal cultural knowledge and perspectives.

Training program model

The Aboriginal Mental Health Traineeship program model has three components: workplace, clinical placements and university.

The three components together will develop qualified mental health professionals and equal members of the health service's multidisciplinary mental health team.

Trainees are full-time employees in the mental health service during the three-year program and will be offered full-time ongoing employment following successful completion of the three-year degree.

Cultural supervision

The trainees have access to cultural supervision and support during the program. The trainees will also attend the Victorian Aboriginal Social and Emotional Wellbeing Gatherings coordinated by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). These gatherings are held twice a year. Mental health services are required to release the trainee to participate in cultural supervision/support activities.

Expected benefits

• permanent positions are created in the health service for Aboriginal people who successfully complete training
• the number of Aboriginal people working in the mainstream mental health system is increased
• the mental health workforce has the appropriate proportion of Aboriginal staff employed
• training local people builds the capacity of the broader community
• Aboriginal employees are ambassadors for culturally safe services.

Locations

Trainees will be located at eight area mental health services across metropolitan and rural Victoria. These are: Eastern Health, Bendigo Health, Alfred Health, Peninsula Health, Latrobe Health, Mildura Base Hospital, Monash Health and Forensicare

Aboriginal clinical and therapeutic mental health positions

This initiative is supporting clinical and therapeutic mental health positions in selected Aboriginal community-controlled organisations across rural and metropolitan areas.

The initiative aims to increase the workforce available to deliver culturally responsive, trauma-informed services that can address the social and emotional wellbeing and mental health needs of Aboriginal people in Victoria.

The clinical and therapeutic mental health positions are selected from a broad range of disciplines (such as mental health nurses, occupational therapists, psychiatrists, psychologists and social workers), as determined by the selected service provider.

It is not essential that the positions are filled by individuals who identify as Aboriginal or Torres Strait Islander.

Locations

The clinical and therapeutic mental health positions are located at 10 Aboriginal community-controlled organisations:

• Ramahyuck and District Aboriginal Cooperation (Morwell)
• Victorian Aboriginal Child Care Agency
• Mallee and District Aboriginal Health Service (Swan Hill)
• Healesville Indigenous Community Services
• Gunditjmara Aboriginal Cooperative
• Ballarat and District Aboriginal Cooperative (BADAC)
• Budja Aboriginal Cooperative
• Winda-Mara Aboriginal Corporation
• Dhauwurd-Wurrung Elderly and Community Health Service
• Kirrae Health Services

Koori Mental Health Liaison Officer Program

The new Balit Murrup initiatives complement and support the existing Koori Mental Health Liaison Officer (KMHLO) program which has supported rural and regional hospitals to deliver high quality, culturally responsive care for over 15 years.

The KMHLO program aims to improve access for Aboriginal people to mental health services and support high quality, holistic and culturally appropriate health care and referrals for Aboriginal people.

KMHLO staff in rural and regional hospitals have a vital role in supporting Aboriginal clients, their families and the delivery of culturally responsive care for Aboriginal clients. KMHLO staff can also help build relationships with local Aboriginal communities and can support discharge planning and primary health care referral.