Seminar notes

Prevention of alcohol-related harms in

Victorias Koori Communities:
Research, policy, practice and Indigenous ways of working
Free interactive seminar and forum held from 10.00am to 12.30pm on
Thursday 3 September 2009, Aborigines Advancement League, 2 Watt Street, Thornbury
In contextalcohol (and other drugs) in
Indigenous communities
Professor Ian Anderson, Onemda VicHealth Koori
Health Unit, The University of Melbourne

Council of Australian Government (COAG) national

framework for preventing family violence and child
abuse in Indigenous communities

National Drug Strategy Aboriginal and Torres Strait

Islander Peoples Complementary Action Plan
20032009

National Alcohol Strategy 20062009, along with the

Complementary Action Plan.

Onemda is a Woiwurrung word for spirit, wellbeing and

love.
Professor Ian Anderson discussed alcohol-related
harm using a burden of disease (BOD) framework, and
looked at how national policy is dealing with this issue.
The life expectancy of an Indigenous person is 11 years
less than that of a non-Indigenous person.
Burden of disease analysis based on data from 2003
show that Indigenous Australians have:

National Strategic Framework for Aboriginal and

Torres Strait Islander Health 20032013 has identified
immediate priority areas including emotional and
social wellbeing (mental health problems and suicide,
the protection of children from abuse and violence,
response to alcohol, smoking substances and drug
misuse).

Two and a half times the BOD of non-Indigenous

Australians

Five times the BOD due to diabetes

The policy documents contained the following common

themes:

Four and a half times more BOD due to

cardiovascular disease

Four times the BOD and disability due to intentional

injuries.

Dealing with a complex set of inter-related issues,

such as social and family harm, violence, abuse and
alcohol and other drugs (AOD).

Responses include leadership and capacity building

within communities, community organisation,
partnerships and tailoring to the Aboriginal context.

Tackling underlying causes, such as

intergenerational processes, poverty and broader
social determinants of health; along with access to
health services, rehabilitation and other specialist
services.`

The Indigenous Health Gap shows the difference

between observed BOD, and BOD for all Australians,
and included:

Tobacco17 per cent

Alcoholfour per cent

Illicit drugsfour per cent

Intimate partner violencethree per cent

Unsafe sextwo per cent.

Policy context
The following were discussed:

National Strategic Framework for Aboriginal and

Torres Strait Islander Health 20032013

Recent developments
On 24 March 2008, Prime Minister Kevin Rudd, the
leader of the Federal Opposition and significant leaders
in the health sector, signed a pledge to close the
Indigenous health gap by 2030, and to close the equity
gap in health service provision by 2018.

The National Indigenous Health Equality Council was

established in July 2008, and draws membership from
Australian Government and the Aboriginal and Torres
Strait Islander community. Its aim is to provide advice on
commitments made under the March 2008 Statement of
Intent on achieving Indigenous health equality.
COAG targets include:

Closing the life expectancy gap in a generation

Halving the child mortality gap in ten years

Halving the literacy and numeracy gaps

Halving the employment gap within a decade

Halving the gap for Indigenous students in year 12 by

2020

Providing access to early childhood education for all

four year olds in remote Indigenous communities, in
five years.

Aboriginal people were admitted to hospital for AODrelated conditions more often than non-Aboriginal people.

Males are admitted at approximately twice the rate as

females.

Those between the ages of 25 and 64 have higher

numbers of admissions per person than older or younger
people.

Mental disorders

Koori people traditionally perceive their health in terms of

physical health, as well as the social, emotional and cultural
Prevention of alcohol-related harms in Victorias wellbeing of their community. For this reason, a holistic
approach to treatment is necessary.

Indigenous communities

Emotional and social difficulties, such as depression, suicide

and AOD abuse are huge issues in Koori communities. Mood
Karen Milward gave a presentation of her DrugInfo Issues disorders can be set off by stressful events or situations.
Paper, Prevention of alcohol-related harms in Victorias
Mental health-related problems are a frequent cause of
Koori communities.
hospital admissions for Koori people in the 15 to 44 year age
Problematic alcohol consumption is a major contributor
group.
to the poor health status, social problems and shorter life
Victorian hospital admissions data
expectancy of Australian Indigenous people.
The Issues Paper considered the views of key informants Renal failure is the leading cause of hospitalisation for
Aboriginal people. Other frequent causes of admission
with professional experience in providing services to
include
respiratory diseases, mental health problems,
Koori people, combined with a literature review, to identify
circulatory
disease, pregnancy and cancer (in the 55+ age
issues impacting on alcohol-related harms in Victorian
group).
Koori communities, and service response options
Karen Milward, Indigenous Business Consultant

available in Victoria.
Victorian research showed that in Department of Human
Services (DHS) treatment services in 2003:

Data are available on hospitalisations due to self-harm,

AOD misuse and mental health conditions, but are likely
to underestimate the actual number of Aboriginal people
admitted to hospital. Those aged between 30 and 44 are the
most likely to be admitted to hospital.

57 per cent of Indigenous clients were receiving

treatment for an alcohol-related issue

Multiple drug use was an increasing trend in Koori

communities

Alcohol and cannabis were commonly used together

Injecting equipment was commonly shared by injecting

drug users, resulting in a high risk of transfer of blood

borne viruses.

Main conclusions

The literature review showed:

Victorian Indigenous women identified alcohol as a

major cause of violence and chaos in their lives.

Aboriginal people use community-based AOD services

at 14 times the rate of non-Aboriginal people.

In 2006/7, about 2100 Aboriginal clients received

almost 4000 courses of AOD treatment.

People admitted to hospital for alcohol-related

conditions are generally older than those admitted for
other drug-related conditions.

Alcohol-related harm in Victorias Koori communities is

a hidden problem, as there are currently few sources of
specific, accessible data or information about the extent
of the problem.
It would be helpful if Koori-specific data could be shared
with internal and/or external stakeholders, so that we
can fully understand the impacts of alcohol in these
communities.

Alcohol-related treatment and hospitalisation is usually

accessed by Koori people outside the region where
they live. This is not surprising as most Koori people live
outside the Melbourne metropolitan area where most
services are located.

Action taken in this area will also address violence and

poverty experienced by Koori communities.

Services must particularly assist individuals who have

More information
For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on
tel. 1300 8585 84, email druginfo@adf.org.au, or see our website www.druginfo.adf.org.au

an addiction to alcohol, but lack family support and

personal strength to seek help for their problem.
More research on AOD-related hospital admissions is
needed to identify the appropriate actions to be taken to
prevent alcohol-related harm issues.

Case study 1: Ngwala Willumbong & Youth

Substance Abuse Service program
Glenn Howard, Program Coordinator, Ngwala
Willumbong Co-operative Ltd
Glenn Howard gave an overview of the development
of the Koori Youth Alcohol and Drug Healing Service,
a residential drug and alcohol program, which is a
partnership between Youth Substance Abuse Service
(YSAS) and Ngwala Willumbong.
The project plan consisted of three phases:

Phase 1: Development of the service model and

operational guidelines, and the establishment of a sixbed interim service.

Phase 2: Establishment of a 12-bed, purpose-built

facility, and transfer of the service to this site.

Phase 3: Transition of the service to Ngwala within

four years.

Originally a diversionary program for young Aboriginal

people charged with substance misuse offences, the
program now services adult Aboriginal men who have
substance misuse problems, and may also have additional
problems, such as legal issues. Participants may be
voluntary or referred by the court.
Warrakoo is run by the Mildura Aboriginal Health Service
(MAHS), which is part of the Mildura Aboriginal Corporation
(MAC), and is a member of the Victorian Aboriginal
Community Controlled Health Organisation (VACCHO).
A new, structured program of work and activities is
currently being devised for Warrakoo clients. This
will include farm work, one-on-one counselling,
group programs, psycho-educational groups, anger
management/self esteem workshops, TAFE programs and
a living skills program.
Therapies will include narrative therapy, mindfulness and
cognitive behavioural therapy. All programs will have a harm
minimisation focus, remembering that not all clients will want
to be abstinent when they leave the service and will need
self management and help-seeking skills.

The project began with the lease of a large property in

Bittern, Victoria. The team faced opposition from local
residents, but with the support of local government
and police, the project went ahead, a team of staff was
employed, and the first young people began to participate Further programs to be offered include day workshops and
programs for mens and womens groups, short camping
in the program.
trips, and access to distance education or literacy programs.
Respect for each others systems, open communication
Clients have access to a general practitioner, nurses, a
and inclusive decision-making processes were vital in
dietitian and Aboriginal health workers who travel out to
building the successful partnership between YSAS and
Warrakoo. There are also a range of services including
Ngwala Willumbong. Friendship, trust, willingness to
dental treatment and eye health screening, which are
learn and change, and shared belief systems were also
available at MAHS.
considered to be important.
The service faces a number of difficulties, many of which
Aerial photographs, maps and a virtual tour were
are due to the remote location of the service. For example,
presented to show the site and layout of the five
clients usually need to travel long distances for residential or
acre block. The permanent facility will include two
hospital-based detox, and many are reluctant to be too far
accommodation units, meeting area, administration
away from their family and community.
building, communal building, gathering area, fire pit,
cultural space and basketball court.
The buildings are a blend of colourbond, glass and
cement. Cultural elements will include internal art works.
The design has a universal approach, aimed to appeal to
young people.

Case study 2: Warrakoo Program

Sandi James, Drug and Alcohol Counsellor, Mildura
Aboriginal Health Service
Sandi James discussed the Warrakoo Transition Centre,
located 120 kilometres from Mildura, where she has
worked for almost three months.

It is difficult to attract and retain trained staff due to the

isolation of the property, and counselling can currently only
be offered on a fortnightly basis because of a lack of MAHS
staff, and time available, to travel out to Warrakoo.
A range of activities are underway to develop the service.
At the moment, all Warrakoo staff are in the process of
gaining their Certificate IV (Drugs and Alcohol), networks
are being formed with other services and training
pathways are being investigated so that community
members can be involved in more health and education
activities. These initiatives will all contribute to good health
outcomes for the community.

More information
For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on
tel. 1300 8585 84, email druginfo@adf.org.au, or see our website www.druginfo.adf.org.au