Indigenous Governance - Commissioning & Partnering
Organisations that are contracted to provide mental health and social and emotional wellbeing support to Indigenous people, and funders of services including Primary Health Networks (PHNs), should ensure they work in meaningful partnerships with Aboriginal and Torres Strait Islander communities, including through their governance, planning and service design, and employment practice.
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Binarri-Binyja Yarrawoo (WA)
In May 2019 Empowered Communities brought together Aboriginal organisations and leaders from across the East Kimberley to talk about Language and Culture. Together we;
• Shared stories and experiences to build a shared understanding of what Language and Culture means.
• Explored our hopes and aspirations for Language and Culture.
• Named what success would look like when Language and Culture are strong.
• Began to plan how we can track and measure progress.
- Circulate Language and Culture work across the wider East Kimberley and build in feedback
- Develop an evidence brief to help advocate for investment in Language and Culture.
- Build capacity in measuring and evaluation across the ACCO sector.
- Test the indicator framework in the Wirnan project Monitoring and Evaluation plan
- When Language and Culture are strong we have strong rarring ngoondenging (good bingy – good feeling).
- People are practicing culture as part of life – not because theyget paid for it.
- We are talking language everyday, everywhere and we practice traditional marriages and kinship.
- We feel whole. We feel at home. Like when we are on our own Country. There is connection and togetherness with each other and with Country. Self-identity is strong and our family and home life is happy.
- We are positive, inspired, motivated. There is good interaction, communication and sharing. There are strong leaders and good guidance.
- We are proud because kids are participating in culture and they feel pride in their identity. We are proud because we help each other to do cultural activities, we are inclusive and acceptin
- We are proud to belong.
- Culture has to exist in modern life. Young people need to be involved as learners.
- Language and Culture will be in the media and showcased to the rest of the world and everyone will be proudly speaking language.
- There will be more gatherings in community where the whole community will join in – not just the same group.
- Bad behaviour will not be rewarded – kids who behave right way will be included in opportunities.
- There will be more focus on the positive: good news stories and celebrations
- No jealousy. Respect for Elders. Healing camps.
- Togetherness. Back to Country trips.
- Communicating with the ancestors.
- Organisations will be working together to support cultural practice, including funerals. Staff won’t ‘just be doing their job’
Dream It Forward
The Dream it Forward program (DIF) is a ConnectGroups small grants program focused on identifying, strengthening, sustaining, or adding value to grassroots, community-led projects that:
- Positively impact the social, emotional and spiritual wellbeing of Aboriginal and Torres Strait Islander peoples, families, and communities in Western Australia
- Strengthen cultural identity and apply culturally-informed ways of healing to improve social and emotional wellbeing
- Reduce risk factors and operate a range of activities to increase community protection against psychological distress
Phone: (08) 93646909/Email: firstname.lastname@example.org
Dream It Forward is a small grants program which brokers funding to community initiatives that address the social and emotional wellbeing of Aboriginal and Torres Strait Islander people, families and communities in Western Australia based on needs identified by the community.
Dream It Forward is a bottom-up grassroots model that empowers community leadership, capacity, participation and co-production to achieve a range of outcomes related to suicide prevention. Recognition that Aboriginal and Torres Strait Islander communities have a holistic, whole-of-life approach to mental health, health, spirit and culture drives its methodology and engagement with elders and community leaders. Strengthening culture and cultural identity is at the heart of all funded projects.
Successful grant projects cover a wide variety of place-based tools, methodologies and services to engage communities and address trauma and healing by activating and strengthening cultural identity and connection to Country.
A key to Dream It Forward’s acceptance within community is its decolonising methodology. Recognition of the impact of transgenerational grief and trauma caused by colonisation, dispossession and the successive government policies which have resulted in persistent disadvantage and distress underpins the program.
As informed by best practice, stakeholder engagement and available literature, Dream It Forward projects consider the following three-branched approach:
- Address the underlying social and emotional wellbeing issues impacted by intergenerational trauma and grief at a community level which is contributing to family and community breakdown, dislocation from culture and Country, suicide rates and disadvantage.
- Develop culturally secure divisionary opportunities on and off community, particularly for youth and at-risk groups that:
- Compliment mainstream treatments
- Promote community strength and wellbeing
- Reconnect people back to family, community and Country
- Promote investment to develop micro-enterprises based on community aspirations and to promote local leadership and skillsets, particularly among women.
Dream It Forward is further informed by the National and Torres Strait Islander Suicide Prevention Strategy (2013) respecting Action Areas 1 and 2, the National Empowerment Project, and the Education and Health Standing Committee “Learnings from the Message Stick – The report of the inquiry into Aboriginal youth suicide in remote areas”.
As a place-based initiative, which capacity builds local leadership, Dream It Forward also aligns to the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) Final Report recommendations of community leadership being important as responses cannot be standardised across differing communities but must reflect local needs.
Strengthening culture and cultural identity is at the heart of all funded projects as best practice and available literature indicates that cultural legacy and social and emotional competencies are preventative of suicide.
The Dream It Forward model operates as an intervention tool delivering primary and secondary mental distress prevention initiatives to Aboriginal and Torres Strait Islander people, families and their communities by disrupting risk factors and as a social and emotional wellbeing activity by increasing protective factors at a community level.
As a primary prevention initiative, an outcome of the model is to prevent the onset of mental distress at a whole-of-community level, by strengthening communities to take action, and filling a gap where services have either been inaccessible or delivered from top-down. Projects are co-produced by Elders and community leaders who identify where the social and emotional wellbeing needs are the greatest and address them directly within community.
Dream It Forward operates within a holistic decolonising framework that recognises the impact of underlying trans-generational grief and trauma which have resulted in persistent disadvantage and distress while respecting the imperative of connection to Country, culture, spirituality, family, and community in healing and wellbeing.
As a primary prevention initiative, an outcome of the model is to prevent the onset of mental distress at a whole-of-community level, by strengthening communities to take action and filling a gap where services have either been inaccessible or delivered from the top-down. Projects are co-produced by elders and community leaders who identify where the SEWB need is the greatest.
Projects advancing secondary prevention strategies add value to the work being delivered through existing Aboriginal Community Controlled Organisations (ACCOs), and service providers, to at-risk communities and groups by promoting new initiatives, program sustainability, early intervention and on-going recovery.
The response to Dream It Forward increased as the program gained traction as an effective and needed model for community-led, place-based initiatives around positively impacting Aboriginal social and emotional wellbeing and healing.
Dream It Forward has been active since 2014 and is funded by the Mental Health Commission. It has awarded over 100 projects since inception. ConnectGroups publishes stories books to qualitatively demonstrate project impact. (link to references: https://connectgroups.org.au/resources/dream-it-forward-booklet/)
Participants include the entire community or are specific to families, children, young adults, men and women. The location of the programs range throughout Western Australia and include Perth metropolitan programs, small town programs and remote camps. An example is the Bidydanga Community Men’s Health and Wellbeing Group which aimed to improve the health and resilience of men in this area through camping on their land.
Another example is the established Kapululangu Aboriginal Women’s Law and Cultural Centre using funding from Dream it Forward to hold on-country workshops where senior law women instructed younger elders and young women. The workshops allowed for yarning about mental and physical health and strengthened the relationships between these women.
Dream It Forward has been formally evaluated internally. As part of its funding, Results-based Accountability (RBA) is applied across all project cycles. RBA is a planning, evaluation and continuous improvement methodology applied to the community sector which supports measuring outcomes for each funded project and service provided to stakeholders. The evaluation framework ensures that the program remains responsive to both stakeholders and program KPIs, relevant to community and best practice, and is effective.
There are seven mutually non-exclusive areas that applicants can choose upon which to base their projects. Nearly all (9 in 10) projects focus on social and emotional wellbeing with three-quarters including strengthening individual, family, kinship and community wellbeing as well as prevention and early intervention of psychological distress. Few are specifically targeting CBPATSISP assessment areas of suicide prevention or training however it is acknowledged that these projects are building the capacity and resilience of individuals and the community.
1. Stories from our Dream It Forward Program: An innovative small grants program for Aboriginal and Torres Strait Islander communities in Western Australia. Issues 1 – 3. [Available https://connectgroups.org.au/resources/dream-it-forward-booklet/
Primary Health Networks
There are 31 Primary Health Networks (PHNs) across Australia whose role is to adopt a commissioning based approach to planning local health services with the aim of improving the health and wellbeing of all people living in their region. Each PHN has a responsibility to work collaboratively with stakeholders across the health and social care economy to set the strategic direction, drive service improvements and achieve system change. This is particularly essential with respect to enhancing the health and social and emotional wellbeing of Aboriginal and Torres Strait Islander people.
Commissioning for Aboriginal and Torres Strait Islander suicide prevention and SEWB and Mental Health via PHNs requires a strategic process of establishing a best practice governance process and working with relevant stakeholders including ACCHS and Elders to co-design, co-deliver and manage services to meet the needs and improve outcomes for Indigenous populations within the most culturally responsive, effective and efficient manner.
According to Dudgeon et al (see PHN governance report) when commissioning elements of integrated approaches, a PHN should aim to employ local and community people as much as possible.
- Where service gaps are identified and when commissioning suicide prevention activity, a PHN should aim to build community capacity (including ACCHS and other community-controlled organisational capacity) as much as possible, including as an important part of committing to the empowerment of communities in the context of suicide prevention.
- An effective way of exploring potential untested elements in any integrated approach is by Participatory Action Research (PAR) methodologies.
- PAR-based evaluations and processes should be disseminated to help build an increasing evidence base for Indigenous systems approaches to suicide prevention and suicide prevention in general, and should support the expansion of integrated approaches to suicide prevention in Indigenous communities across Australia.
Primary Health Network Commissioning Principles
These Principles have been designed by PHNs in consultation with the Department of Health, to assist in meeting the strategic objectives of the PHN Program.
- Understand the needs of the community by analysing data, engaging and consulting with consumers, clinicians, carers and providers, peak bodies, community organisations and funders.
- Engage with potential service providers well in advance of commissioning new services.
- Putting outcomes for users at the heart of the strategic planning process.
- Adopt a whole of system approach to meeting health needs and delivering improved health outcomes.
- Understand the fullest practical range of providers including the contribution they could make to delivering outcomes and addressing market failure and gaps, and encourage diversity in the market.
- Co-design solutions; engage with stakeholders, including consumer representatives, peak bodies, community organisations, potential providers and other funders, to develop evidence-based and outcome-focused solutions.
- Consider investing in the capacity of providers and consumers, particularly in relation to hard-to-reach groups.
- Ensure procurement and contracting processes are transparent and fair, facilitating the involvement of the broadest range of suppliers, including alternative arrangements such as consortia building where appropriate.
- Manage through relationships; work in partnership, building connections at multiple levels of partner organisations and facilitate links between stakeholders.
- Develop environments high in trust through collaborative governance, shared decisionmaking and collective performance management.
- Ensure efficiency, value for money, and service enhancement.
- Monitor and evaluate through regular performance reports; consumer, clinician, community and provider feedback, and independent evaluation.
National Safety and Quality Health Service Standards User Guide for Aboriginal and Torres Strait Islander Health
The Australian Commission on Safety and Quality in Health Care has developed a user guide to ensure health providers provide safe and high-quality health care for Aboriginal and Torres Strait Islander people within the National Safety and Quality Health Service Standards. The Commission has identified six actions to help address the inequities in access and care experienced by Aboriginal and Torres Strait Islander people to improve health outcomes. These actions were defined following a comprehensive consultation process. Their implementation will help position the health system to provide all Aboriginal and Torres Strait Islander people with the culturally safe and clinically responsive health care they need. This user guide provides practical strategies and examples on how to implement these six actions in health and mental health service organisations.
Indigenous Governance Framework
The importance of Indigenous Governance and the need for best practice principles and strategies to achieve it cannot be overstated. It is now increasingly recognised that Indigenous Governance and Data Sovereignty are essential to make the system changes required to achieve Indigenous suicide prevention across all Indigenous population groups.
The Centre for Best Practice in Aboriginal Torres Strait Islander Suicide Prevention has developed an Indigenous Governance Framework in partnership with the LifeSpan Program within the Black Dog Institute, funded by the Australian Government Department of Health. The framework provides an in-depth discussion of the principles and importance of Indigenous governance in the context of developing, implementing and evaluating suicide prevention programs and services.
This is the second Guide undertaken in partnership with the Black Dog Institute to support Primary Health Networks (PHNs) working with Aboriginal and Torres Strait Islander communities and organisations to co-design and co-implement integrated approaches to suicide prevention.
Implementing Integrated Suicide Prevention in Aboriginal and Torres Strait Islander Communities: A Guide for PHNs
A starting point for any organisation wishing to improve their Indigenous governance is to find out about the history of the local Aboriginal and Torres Strait Islander people and to listen to their experiences historically and today. Through building a relationship with the community, shared objectives can be established.
The Framework is a supporting document to Implementing Integrated Suicide Prevention in Aboriginal and Torres Strait Islander Communities: A Guide for PHNs (2018).
2017 LifeSpan Implementation Framework: Implementing Integrated Suicide Prevention
Indigenous Governance Toolkit
The Australian Indigenous Governance Institute has developed the Indigenous Governance Toolkit. This toolkit is an online resource developed for Indigenous nations, communities, individuals and organisations searching for information to build their governance. It covers all the basics – your rules, values, culture, membership, leadership, and decision making – and has many examples of ideas that work from other groups, tools to help you get started, and useful guidance to sustain your efforts.
Culturally Responsive Aboriginal Healthcare Framework Guide 2018-2020
A Framework is designed to guide the implementation of culturally responsive Aboriginal Healthcare across the Hunter, New England and Central Coast Primary Health Network.
The Framework, developed by the Hunter New England and Central Coast PHN, supports a collaborative approach to improve the integration and coordination of Aboriginal and Torres Strait Islander primary healthcare services. The Framework supports holistic approaches that consider the cultural and social determinants of health and is underpinned by core values, including self-determination, equity, respect, and empowerment.