 Good evening, everyone. My name is Dana Shen and I'll be facilitating this webinar tonight. Welcome to all of you, the 500 plus people that have joined us tonight. Before we get started, I wanted to – MHPM wishes to acknowledge the traditional custodians of the land across Australia upon which our webinar presenters and participants are located. We wish to pay respect to the elders past and present and future for the memories, the traditions, the culture and hopes of Indigenous people. Before we get into the webinar tonight, there's a couple of things I just wanted to take you through. First of all, a few words about the webinar series. Welcome to the third webinar in our fourth series. In the coming months through to next year, we will be bringing you webinars on supporting the wellbeing of infants and children through a trauma-informed lens in February 2022, assessment and engagement with infants and children in April 2022 and building parents' understanding of infant mental health in June 2022. So please join us when you can and if you can at those different webinars in the future. Okay, so now let's move on to the webinar tonight. So of course you would have already seen previously the learning outcomes that we're going to be focusing on tonight. So what I think I will do is now introduce the panel. Now previously you would have already seen their bios, so I won't be going into that tonight. But I want to introduce the two panelists we have tonight, Professor Trisha Nagel, psychiatrist and senior researcher from the Northern Territory and Adele Cox, National Sector Development Manager from Snake in Victoria. And of course there's me, you're facilitated if it's not. So before we get into really responding to the kind of questions that people raised towards this webinar, I thought it would be important to just get to know our panelists a little bit more. So first of all, I have a question for both of you just to hear a little bit a bit more about each of you. So people have had a chance to look at your bios, but I thought it would be good if you could spend a little bit of time on yourselves. So the question that I have for both of you first is what are one or two of the key moments in each of your lives that bring you to the work you do? So Adele, I wondered if you could start first. Thanks, Dana. I'd like to firstly just acknowledge that I'm actually sitting on Warringerie lands here in Melbourne as part of the Greater Kulin Nation and would like to pay my respects to elders past, present and emerging. Oh, there's a there's a couple of things. I mean, one of them is, I guess, you know, I straight out of school, I kind of went down a path where I thought I wanted to become a lawyer. I had journalism as my kind of second preference and ended up going down that route. But I come from a family that have very strong connections in history with Aboriginal community control health sector. So health ended up being something that, you know, I ended up, you know, also kind of venturing down, but specifically in terms of mental health and suicide prevention. So when I was younger, and my story is one that's, it's not too uncommon for a lot of Aboriginal people. And it's one that I share to kind of give context to, you know, why I ended up in the suicide prevention and broader mental health space. And for me, it's a sad story, a bit of a sad story. So when I was when I was 21, I had a cousin who was only nine years old who took his life in Broome. And back then, which was 1998, it was something that was not seen or heard in this country. And so I often tell people that, you know, my path, the path that I ended up going down in terms of career, but also my interest in terms of learning more about mental health and broader social emotional wellbeing, you know, really came from that episode and that, you know, that incident. And for me, it was a learning journey. I wanted to and I felt like I needed to explore more, you know, why did this happen? What, you know, possesses a nine year old to take his or her life. And what, you know, was a what started out as a pretty, you know, sad and sorry story is something that has seen me now, you know, at my age over the last two decades, and certainly more than more than half my age, or more than half of my life, rather, kind of, you know, walking down that path and ending up in that space. That interest then kind of continued on and I was fortunate to be blessed and mentored by, you know, the great Fiona Stanley. And so I was involved heavily with some early research work that the Telethon Institute did on the WA Aboriginal Child Health Survey. And so that then continued this, you know, this absolute interest and yearning to learn more and to kind of continue in that space. So it was, yeah, it was, it was somewhat by accident, but I often say that I think I was guided by my old people as well in terms of ending up in this space. Thanks so much, Adele, for sharing that. And Trisha, how about you, those one or two key moments that brought you to this place and your role? Absolutely. I just want to acknowledge that I'm on Larrakeer country and pay respect to traditions and the elders of the land and talk about how joyful it was when I came for the first time. So that's one of the key points is I came for a short visit nearly 40 years ago and loved the country, loved the people, loved the colours, loved the bush, and then came back as a psychiatrist and having also many young doctors here. And as a psychiatrist, another key moment for me was working with Aboriginal mental health workers on the inpatient unit and seeing so many unwell people coming in regularly, people from remote communities, clearly not being able to experience a culturally safe environment and not being able to be communicated with very well. Fortunately, we did start having Aboriginal mental health workers from then on, but it was very early days in recognising how important it was to to have resources and opportunities for people to speak their own language, for example, to reach out to traditional humans through their families. So that was the second one. The third one is when we as a team went over to Mendes and we had five years of consultation, five years of funding from the NH and MRC to consult around the territory in terms of what we could do. And that was the beginning of a research program that is now two decades long, seeking to render some simple messages available and especially to breach cultures. So non-Indigenous clinicians, such as myself, have some resources and some guidance in terms of improving people's possibility for our thoughts. Wonderful. Thank you, Trisha. Thank you both for sharing some of your story. I know there's so much more, but we're going to get on to the other questions now and I'm sure that some of these will come through as we continue on. So now I do want to take you through a range of questions that are really going to be responding to those learning outcomes and also to what registrants had actually asked us about what was important to them. So let's start with the issue around cultural identity and really understanding that. So I wondered, Trisha, if you could start first, what does cultural identity mean to our peoples and why is it so important to our people? It's about a sense of belonging, sense of connection. It's about who you connect to, where you connect, country and speaking from the experience I've gained from people telling me and also through our research. It's about being able to do the things that are important to you within your culture and what's important particularly is that it's linked with health. It's linked with social emotional well-being and it's linked with health and we know that ourselves that if we feel connected, you know, especially going through the recent COVID year, we know how important those social connections are. If we feel connected, we're safer, we're more likely to be able to find pathways to help. So that's a really important other side to this, that it's not only is it good for your social emotional well-being, good for your health, international research and local research shows that, you know, if not our personal experience, but it also is a protective measure in terms of not being isolated, not being vulnerable and unable to seek help. So those connections are particularly important. Thanks Trisha. And Adele, how about you and from your perspective, what does cultural identity mean to our peoples and why is it so important? Cultural identity for us is, you know, it's the core of who we are. As Trisha alluded to, it's knowing who our mob are, you know, where our country is, that connection. And also I guess understanding and part of that is the strength in terms of where particularly young persons' identity is strong, you know, their mental health is better for it. And as Trisha said, you know, there's numerous, you know, research and evidence that's around internationally, but also locally that, you know, confirms that notion. And it's, you know, being at the core, it is about that belonging, but it's also understanding our place, you know, within our mob, within our tribes and within society. And it's absolutely important because it is the strength that we have and it is the, you know, the thing that provides particularly young people with the tools that they need in terms of just being able to live in two worlds for a lot of them. Wonderful. And I think just to sort of highlight a couple of things that particularly stuck out to me that were really important, I think the issue about it being a protective factor, it's actually a protective factor. And I think Trisha, you made that point very clearly. But also, Del, you talked just then about walking in two worlds. Can you just expand on what you mean by that for our listeners tonight and our watchers tonight? Look, there's pressures from society. There's pressures and expectations that are set from, you know, our communities, our families often. And, you know, whilst we promote the strength that that connection to culture and country and community has, you know, the couple with that is the issue of wanting to ensure, for instance, that, you know, our kids are having, you know, the most of the opportunities presented either through education, through, you know, training and employment opportunities and the like. And this notion that I think, you know, two decades ago, you had to do one or the other. But I think we've quickly, you know, grasped the issue and the conversations that we've needed to have to actually promote the fact to our kids that, you know, you can have both, you know, have the best of both worlds in terms of being strong and knowing who you are, having that connection. But also, you know, continually looking out for those opportunities as they present. And that's why the early years and particularly around the early learning stuff is really critical because it starts to embed from an early age that understanding that our kids need in order to, you know, know that they have that choice. They can absolutely do both things. They can respond to what society pressures them to do in terms of, you know, becoming or being good citizens and contributing to, you know, the economic kind of growth of our country and our nation whilst also contributing back to the importance of what we know it is to be Aboriginal and or Torres Strait Islander and providing that, you know, that input into our family and our community setting as well. Absolutely. And I imagine and certainly from my own experience, a number of us carry that as a bit of a tension to, you know, to be able to do both, even though there's opportunities and wonders in both. So, you know, I just wanted to sort of name that because I'm about to ask you both another question about this because I think both of the things that you've said is really important. We want to focus on protective factors, the importance of connection, understanding the two ways in which we live. And I wonder now, in particular for our non-Aboriginal colleagues who are wanting to support Aboriginal and Torres Strait Islander children to connect with culture, including where, and I think this is a really important point that people will be interested in, including where children have had minimal or no connection to culture. That came up a lot in the questions. What should they be thinking about? What if a child doesn't want to connect? What should they do? So let's start from the first part of that question, which is given we want to connect children with culture, even those that have not had the connections to culture in their lives, what should our colleagues be thinking about? Trisha, can I start with you? Yes. Well, I always begin in the therapeutic space there at considerations, and then there's what you might do in your team and your organisation, and I think we'll cover all three of those. But to start with the therapeutic space, the first and central thing to do to help anyone in social emotional wellbeing is to develop trust. And there are a number of strategies to do that before a family or a child is walking into your room. And I might mention them now, so that we're really clear that we can have, and I'm always one for simplifying things, so meeting, greeting, and seating. There's a really good beginning. Who is introducing this child to you to start with? If they're a trusted person in that child's life, your relationship is going to have the potential to start at a high level in terms of trust. And who's going to be in the room, allowing those choices and being guided? And this, especially for a non-Indigenous clinician, I hope for everyone they can find a mentor in a service, in their own service, an Aboriginal or Torres Strait Islander mentor who can help with who should be there, and be there in the room, and guide some of the other important aspects of what I'm going to say, which is apart from plain English pictorial tools, throne and text-based tools, all of your discussion targeted at the age and developmental level of the child. Apart from that, what you're actually wanting to do yourself is to find out what a good cultural support plan would look like for that child, even if they're not ready. And that's where our journey will help to build our own cultural competence. And so some of the key aspects of that would be reaching out to an elder or a mentor from that child's community, always through the family, extended family. And of course, the services that are available to support those children to engage with culture. And by the time you're beginning to build that yourself, you're also aware that you can sort of begin to slip that in as a menu of options, but I would say no one size fits all. There is no hurry. It's a unique journey. Children are growing and developing each time you see them. They might be not ready today, ready tomorrow. Let's be clear what they're ready for. Cultural activities that they go along with another child you've already introduced them to might be much easier than going and participating in a traditional event that they don't feel familiar with. So there'd be a range of ways in which you yourself could not be in too much of a hurry, gather the information, develop those good relationships with other services, average on Torres Strait Islander people who can guide you. Krisha, you mentioned earlier, you made reference to a cultural support plan. And I just wondered. So, you know, part of my experience in my own life is working in really, really big organisations. And you have a lot of policy and you have a lot of bureaucracy, et cetera. And so, what I wonder from your point of view, with a cultural support plan, how do you make that live? There's one thing to write things down and to have it filed somewhere and to put it there. And you can say you've ticked it off. Yeah, I've done that cultural support plan. But how do you make something like that live? Do you have any views about that? Well, as a therapist, we could see with the questions how enthusiastic people are to help and support the younger people that they are working with. And that enthusiasm needs to, you know, we can harness it to build our own cultural confidence. And so, what brings it to life? And again, I'm focusing on the therapeutic space. Is you, as the clinician, developing those partnerships and collaborations with your local Aboriginal Health Service, with the equivalent of the link-up service, with the gather the advice yourself. This is what brings it to life. And recognise that partnership is about commitment for a length of time. So, really being there not only for that family, if you can, you know, be recognised for your change roles. But it is that length of time that that continuity of care, and it's bringing it to life within the work that you do, so that you're ready to present, as I said, a menu of options that you yourself are familiar with, which includes learning yourself about the history of the country, of that child you're trying to. So, Tricia, if I sort of go over what you just said, it's really around actually to make it live is that you're building a relationship. You're being in relationship with all these people. And you've got a personal commitment to your own learning around this. That's some of the stuff that I heard you just say, Tricia. Thank you. So, we're going to come back to that question about what if a child doesn't want to learn. But first of all, I just want to go to Adele first. What's your view about what our colleagues can think about, about connecting Aboriginal and Torres Strait Islander children to culture, particularly those that don't have a lot of connection? Look, I think I liked how Tricia kind of explained the steps and processes. And they are relatively easy. It's amazing though over the years how many times I've been approached by non-Aboriginal clinicians or non-Aboriginal workers who've just come in and they're so fearful of messing up because they want to make sure that they do things right. You're on a journey and as well as critically building that respect and that relationship with your client or with a kid, whether it's maybe with mum or with Nana as their support person, you need patience. And I think absolutely understanding. And one of the things that, as Aboriginal people, we always kind of say to non-Aboriginal people is look, come on that journey with us and understand us and have empathy. Don't sympathize. Don't feel sorry for me and kind of our legacy and that history and the struggle that we as a people have gone through. It is about acknowledging that things have happened in the past that we are still seeing the impact of today in 2021. But it is a journey and it's really important that someone makes that connection at a personal level. I taught medical students as an academic for a long time at the University of Western Australia. I remember one of the first lessons I told to year one and year two medical students was look, when you start to do your rotation on the hospital ward, make sure that you connect with someone. Speak to them as a person. Treat them as a person rather than walking into that ward and just treating the illness. And believe me, the skills you learn as you go on your journey in terms of that learning will forever be something that you take and you can apply them to any other nationality or any other kind of culturally and linguistically diverse person's background. And it's something that we've always said and we've always known if you can get it right in terms of building that relationship, understanding, knowing how to communicate effectively with our mob, then you're in good stead to be able to communicate effectively with many, many others. But it is about that understanding. It is about being patient and I really liked what Trisha said. You might have this little one who is not yet ready to tell their story, not yet ready because they haven't built up that relationship and that trust with you to kind of share what's going on for them in their life. But there will be a period of time where they will be and they may be and you as the clinician or as the practitioner need to be ready to be able to sit down and to then listen and impart some of that story that they're telling to you. Thank you very much Adele and Trisha now I do want to go to that harder question here. You did touch on some of the potential strategies but I wondered what if a child doesn't want to connect with culture? What should our colleagues do in that context? Well I think not being too much of a hurry as we've just heard patients and recognising that there is a unique journey for everyone as I see it. I think those are two elements so that one that we're not hurrying anyone in this space that needs to be managed so carefully. And I think it's step by step. I think it is through advice and that's where family, extended family and a mentor and elders, whoever we can gather into supporting that child can advise us. We're not on our own. We need to develop that map of the supportive advisors around us and I'm talking as a non-indigenous person so that we don't feel that sense of helplessness or concern that we're doing something wrong and we can then hear the good stories of what's happened in terms of other children and the way in which they have managed to take what the first step was for them. But the other point I made is that if we are preparing that way for that child we are also ourselves learning and building our own cultural competence and that means we're more alert to the messages that that child will be bringing to our sessions. Great thank you Tricia and how about you Adele did you have something to add to what we would do where children don't want to make the connection you know to their culture? Look I mean there's a there's a couple of things and one of it is you know hearing that child's story you know understanding the kind of you know their background the family context you know they might be something that's you know that's still there that's traumatic in terms of you know not wanting to you know to kind of engage in that conversation. But you know look our mob and the strengths of our mob is that you know no matter where you go around the country you know our culture and the way that we celebrate and kind of show show off with pride you know our aboriginality and our identity has been morphed into so many different ways that you know we have now you know a regular calendar of events throughout the year that kind of help to celebrate you know we have NAIDOC week we you know at Snake we you know we have National Aboriginal and Children's Day you know we've got National Sorry Day so there are there are so many things on our on our calendar now annually that you know can can help to can help to engage in conversation but also is a way of kind of nicely introducing a conversation as well. But you know I think that the most critical thing is you know not to assume anything but to understand and kind of have that empathy and you know I understand and when people and when kids and when families are ready to you know discuss and you know have a yarn about some of these things as I said you know it may be for some families so traumatic and remembering we're working in a space with the early years where we have a lot of hesitation still of our families and our communities for kids to even disclose their identity because you know although although we're in 2021 you know there is still that fear of some of our families that if they disclose too much you know does that then raise the alarms for you know child protection to come in and that kind of stuff so there's there is still a level of of hesitancy and and distrust in society in general you know and I think understanding that without assuming anything is also important as well absolutely and I think Adele and certainly from my own experiences part of that is because obviously because of the history of what our people have gone through and and the subsequent policies that have occurred it's it's very hard to trust systems so um colleague our colleagues understanding that knowing that it's not personal but you can be seen in a particular type of way sometimes and give that space build the relationship and the trust and you can get to that place where people connect with you instead of seeing a system so that is I think that was a really important point and look I think this is um I think a good time now to think about um the concept of self-determination uh Adele I wondered if you could start first what does that what a self-determination mean for you for me it's it's um it's my ability to uh have control of my life um of the the things that impact on you know my my life and and my family and and it's about recognizing that there's always choice um and it's it's kind of it's a nice segue into that you know from that previous conversation because um we know that for you know for a lot of Aboriginal people there's there's an assumption that you know all of our mob are gonna you know only access the Aboriginal medical service that's that's not the case yes the majority of our mob do and that's for you know many different reasons um but the fact that they are able to have that choice in terms of you know either distance from you know where the nearest clinic is um that you know they may see a general practitioner in a you know in a mainstream clinic as opposed to going to be a a mess that might be 120 k's away um you know it's it's understanding circumstance and and the the circumstance that people and families are in but self-determination is really around uh understanding the the the importance of making sure that Aboriginal people are making decisions uh that they are part of that control in terms of governance that they um can determine uh for themselves um you know what happens from a political landscape um you know that that control and choice around economic um you know circumstances and issues as well and more broadly in terms of you know um addressing other social and broader cultural kind of determinants um and it's it's something that uh you know in Australia we have certainly moved moved in great leaps and bounds in terms of understanding this issue of self-determination and what it means I think internationally through you know things like the UN Permanent Forum on Indigenous issues you know that's really helped to pave the way for other First Nations countries across the globe as well in understanding what self-determination is and what it means and and we you know we know that without that um you know we would otherwise still be feeling the impact um more so than we are on past legislation and policies you know we we have a you know we live in a nation where we were segregated you know there there were rules that applied to us that didn't apply to you know mainstream kind of Australians um that wasn't self-determination that choice and liberty was taken away um so now that we've had this you know this resurgence and this you know absolutely wonderful kind of steps in the right direction in terms of recognizing the importance of things like that um it really has since seen you know our nation flourish um and where it's first you know when it's First Nations people can flourish and thrive then you know the entire country flourishes and thrives. Absolutely and I have to say personally I've got so excited about you know as an aside how many Aboriginal businesses we're seeing come up now but people are changing it's changing things are changing for our people and it's been a real joy to see that thanks Adele um Tricia you've had a chance as a as a clinician to to really walk beside our people and you know I can tell a lot of that has been about listening and taking time given um uh what you've seen and what you've heard what is what has you heard in terms of your understanding of self-determination and how do you support this concept in service delivery and therapeutic work well it's certainly been one of the the challenges is to shift um in through outward shift um clinicians from a standard deficit based approach to people walking into a room or into a clinical setting and to actually have a strengths based approach so it's been one of our our goals really is to say let's start and celebrate the good things in this person's life before we go any further and you know I might say that doing that we start with connectedness which is such a you know potentially such a rich wealth that Aboriginal Torres Strait Islander people have to start with those connections and then move on to strengths by doing that one's actually reversing some of what people usually do and we really have to work quite hard through our through our training and our engagement with clinicians to to say that's that's quite a reasonable thing to do to delay asking that third question which is what's the problem uh so that we gain that information so practically that's been a way of um ensuring that we began on a more equal footing because I've got a family you've got a family I've got strengths you've got strengths and we aim to stay there in the therapeutic principles that we encourage it is this is your session this is your time this is what you want it is your choice we try and avoid direct questions and maximize that sense of focusing on strengths you know focusing on um not leaving as the clinician and when we're heading is that the changes that might make and the but might be made and the decisions that that might be made are not led by us and so that's a form of self-determination within that therapeutic space that's been the primary journey and and really what those five years of consultation and further work have told us to keep doing and keep encouraging people to do it want to learn and for me what's really um powerful about what you've said Trisha too is it means that um what you're in a position that that is of high status you know being a psychiatrist um in the system that we have that kind of role has got a high status but it sounds like to to really make this connection to really allow self-determination to come through we have to be aware of our status and our power in these roles I can I feel that when you talk about it you're really you really think a lot about that I just wonder could you just talk a little bit more about how how you've made sense of that as a psychiatrist in this book well one of those strategies that we we use that I used to engage people was to to draw a house and say this is my house and Darwin here are my two children you know what would you draw you know who would you put in your house and so that strategy was immediately saying you know with people with families and homes together and also just moving again away from something that's high English and not you know impeding communication which we're always at risk of doing and just practicing that that plain English because I am a lot of this work is in remote communities in the Northern Territory and and the local language is not English so it's so important to do to go through those steps and and learn ways of of gathering that information and opening those doors with and there's no doubt that it works best through relationship it doesn't work through your professional role so taking the time to build the relationship is you know where we where we really focus for people it's about trust it's about rapport it's about engagement first second third and only then can you begin to do some therapy work thanks very much Prisha Adele um you know it's it's uh I'm really interested in your view about given what we've spoken about what you spoke about around self-determination what Prisha has spoken about about how we bring ourselves to the work I wondered if you could start first talking a little bit about what you think of conditions required around people to be able to do that I just wondered if you had a view about that um look I mean conditions you know absolutely have to be in a space and a place where it's supportive you know where where from the top down there's absolute goodwill and support for acknowledging that you know there is no one in size that feeds all that your you know your business and how you do it as you know particularly working with Aboriginal communities and with Aboriginal families is you need to you need to forever be flexible things can change at the drop of a hat you know people's priorities change and and one of the things to understand I guess is that um our way of thinking and our way of living is not individualistic what happens to me has greater impact on you know my daughter my mom and dad um you know my siblings so anytime I'm having to make a decision or a call about something I'm not just thinking about what that means for me I'm always thinking about what it also means for you know the rest of my kind of immediate and sometimes extended family um and you know that's uh that can seem tricky um and that can seem uh complex because you know you can imagine someone who's kind of new into the space is then freaking out going well hang on I just asked Adele this question around you know what what kind of um you know management in terms of her anxiety we might want to put in place but you know she she's since told me that you know um one of the you know some of the activities may need to involve her daughter so therefore do I then need to set up a separate plan you know to include include her daughter or her child um and so you know we we we we have a chuckle we're a humorous bunch of people um but it's it's one of the things that um you know over the years a lot of my non-urban friends and colleagues have said uh as they've witnessed you know the way that we kind of network and the way that we um talk about um you know our experience in our families and our friends um that that's one of the things that they're always envious of is the fact that you know what we do isn't just about us um it often is about you know everyone that's close to us in our lives um there was a I'm gonna sidetrack because there was a there was a really nice little question that came in as part of the registration process um where someone had used the example of not wanting to seem to be offending you know a family or or an Aboriginal person if they offered you know something in good will and gesture um and one of the things that I like and I think the example was um clothing you know in terms of offering yeah some some secondhand clothes um there's so many different nice little practical ways that you can kind of um respond to that particular concern or query that that that you know that person's written in about um and one of the ways you could do it is is be anonymous you know if you're in a center or a place um you know where Aboriginal people or clients frequent um you know set up in the corner a couple of little bins you know with a sign that just says you know free um kind of help yourself you know that that way you're not um you're not making someone feel ashamed um because we're very proud peoples um but it's also it's a way of actually showing in a in a really nice way that's so simple um that you care that you care as a worker that your service and your organization cares um and and I see it all the time you know you have a lot of our services Aboriginal services where you'll get donations dropped off of you know bread from bakers delight or something you know this is not a plug for any any promos here but um our families you know they thrive and they know when the drop-off is going to happen so you know they'll be waiting or they'll send the kids in it's little things like this that that help to kind of bridge um you know anxieties that that our families may have about certain organizations or services so there's there's lots of really nice little practical ways if you can kind of bridge that gap and that that um you know concern if someone does have have concern or issue thanks so much for doing what I really like about that um example is and what you've given is that families have the choice to choose they choose if they want those things and that gives power back to people about about their own choices about things so I think that's very powerful Trisha um I any thoughts that you had about the conditions required to make some of this work you know really well around a practitioner around our colleagues yes I just wanted to talk about the importance of elements of cultural competence and that it's a it's a journey for for us and it's an aspiration that we can build our awareness of the cultural lens that we see the world through and our awareness that there are many different worldviews and and ensure in terms of conditions that aspiration is important another condition is to have a positivity related to the difference to really be quite clear that this is this such a rich and wonderful opportunity that we are surrounded by different cultures and and then a final point to that is to have a commitment to to learning to learning how to communicate cross-culturally and to learning more about the the way in which cultures differ and and worldviews different impact upon the way people respond so you know that needs to generate sort of spread through an organization but I would also say we don't have to despair if we're in an organization that hasn't made those changes I think that can be you know different different lengths of time for different organizations but if we think about the therapeutic space we can control and if we think about perhaps our team we can then bring in some some really practical ways of welcoming and giving messages that this is an Aboriginal friendly place with the posters we have the local art that we choose I mentioned who it is that meets and greets you know with wearing shirts perhaps that represent you know the service and a message that Aboriginal people are important and that's also linked with that you know celebrating made or we can really show that we even if it's only in that therapeutic space that's where we're endeavoring to learn and to be and to invite trust thank you Trisha we're going to move on now to some really kind of inviting you to talk a bit about the practical side the strategies that our colleagues might want to think about more strategies so I wondered and Adele this question's for you first in designing or implementing strategies to support cultural needs with children and families what are the key considerations and components you know in the context of intergenerational trauma and domestic and family violence and many other things that our communities are facing yeah what are those key considerations and components I'd like to start with you first with that yeah look I think it comes from you know we we we all touched on it a bit earlier in terms of that issue around governance and making sure that you've got you know good local indigenous leadership as part of you know the core of your business um part of that is is understanding and and you know asking as an organization kind of asking for help and reaching out to you know to make connections with other services where you yourself don't have the confidence to do it or your service isn't quite there yet um we've we've seen uh you know in Australia we've we've got many organizations now and and you know the numbers seem to be increasing annually uh where a lot of organizations now are understanding the importance of making sure that they have uh that acknowledgement to um you know accepting acknowledging and understanding um you know Aboriginal and Torres Strait Islander communities a bit better and so we've got reconciliation Australia who you know support the reconciliation action plans across the country there are different levels I think it's Trisha says you know it's it's nice to acknowledge that you know if you don't have all the answers right now um you know acknowledge that um and and actually do it in a way that is is better for you to then progress so that you do get to a stage where you are feeling more confident um you know and and able to um you know with with some uh level of um uh assurity kind of you know um recognize you know when you've reached that space there's there's um you know connection to other Aboriginal organizations is going to be really critical um and at Snake we do a lot of work and we respond to a lot of kind of calls and queries that come in and and you know I've only been at Snake for uh since since um May but one of the things that I've seen and I've absolutely been loving is is the calls that I get from you know a non-Aboriginal NGO group of you know a small number of daycare centres in you know in rural New South Wales as an example who phoned up saying hey you know we've got four centres under our banner one of them has you know about 30 percent Aboriginal kids who attend the daycare um and one of the things that my staff and our team are always asking for is they they want to learn more they want to understand how they can you know better engage with these kids and with their families in the community um but while we're in that conversation you know our other three centres that you know actually don't have on record any Aboriginal kids you know I actually want them to also go through that learning um and that stuff has been brilliant to kind of be back in this space um you know and and seeing this shift in attitudes um has been absolutely wonderful um and it's you know it's one of the things that you know we're we're blessed that that we are seeing uh and and we don't see enough of these you know good good stories out in the media and you know being promoted um but they are there and they exist um and you know there's there's I mean considerations I think Trisha and I have touched on us you know some of them already from that previous question um I think in terms of organ at the organisational level um I shared a couple of slides here um Donna I might get you to put them up so we did some work with the the National Office of Child Safety um to further explore the 10 principles that were developed by the Australian Human Rights Commission um and part of that work was around responding to uh the child safety standards that were recommended by you know the the previous Royal Commission into institutional responses to child sexual abuse and what government recognised pretty much straight away was that through consultations and through the feedback that they were getting there were a number of submissions that were received from organisations who said look we actually need to learn these but we need to learn it in a practical way that we can understand it and be better uh to you know and be better able to respond to the needs of Aboriginal children uh and Aboriginal families who are coming into you know access the supports and services that we provide uh so the National Office for Child Safety then engaged um Snake and Vacker uh through a partnership where we co-designed and between the three of us as the organisations this very practical guide and resource was then developed it takes you through each of the 10 principles it outlines you know things you might want to consider doing and it's a really nice way of kind of just helping you um and helping you to navigate through you know each of those those principles and and understand better how your organisation um and Trisha's touched on it in terms of you know understanding cultural safety and what that means at an organisational level um so this this is a resource and a tool that was um that was launched midway this year it's something that we are still promoting uh and it's something that I would encourage practitioners uh to you know to get a hold of have a look at and absolutely encourage your organisation to to get on board with this uh because you know we might have the the brilliant will of an individual practitioner who wants to make change and and do good in this you know in this area um but unless they're supported by their organisation and their employer uh then you know we're not going to see much change happen and and it will be a bit of a struggle thank you so much Adele Trisha is there anything that you want to add on to that question so in designing or implementing strategies to support cultural needs with children and families what are some of the key considerations and components was there anything that you'd like to add before I ask you a bit more about um specific examples and strategies and approaches yes we've opened the door we've talked about meeting and greeting and we've had Adele's discussion about the organisation thank you for that document and that great work Adele it's really informative there's a lot of practical strategies um as we open the door I think there are a few things to be put in place bearing in mind um that we need trauma informed care so I just want to add to what we've already talked about and say that empowerment that strengths-based approach to ensure that we're not reinforcing trauma or do the best that we can ensuring that we're very careful in terms of what's available to be seen looking at gender specific entries gender specific issues again just very carefully having that awareness that we don't want to trigger any retraumatisation and having an empowering approach which we've already mentioned choice we've mentioned so choice all over again and outreach so that we're the choice if we can as practitioners as an organisation have that flexibility so that we're not dragging people into what can be or feel like unfriendly scary frightening traumatising environment so one last thing I'll say for the group that we work with transport just if we can help with transport if people are coming in so the really high performing services from my point of view and down and I've got a bus they get out they help people there were quite a few people dealing with one of those basic issues which is about ensuring that we are welcoming and supporting the people who need it. Thank you very much Trisha and now as I kind of slightly introduce there before that question it'd be great to hear from you Trisha to talk a bit more about some specific examples of strategies and approaches that would be useful in one-to-one and group settings people were very interested about that and in particular that rural or remote traditional settings too so kind of like the two-fold question but first of all one-to-one or group settings any perspectives that you can bring on that which would be great. Yes well I think I've mentioned that what we want to do is if possible have an Aboriginal worker from that community there and an awareness of language and literacy differences and that will apply we mustn't again make assumptions in terms of urban versus versus remote certainly here in Darwin there are a lot of remote people just passing through Darwin staying in town so having that openness that's a specific beginning point building trust and then what we've found is that people are not particularly wanting to spend long with us so brief interventions and the direction that we have gone we've been recommending brief interventions that made three reasons one is we still don't have a broad well-being workforce that's culturally competent so we need interventions that don't require a lot of training that's one reason another reason is that people often spend a long time on assessment and you end up with a tired person or family or child and nothing's being delivered in that session so we want to we recommend that assessment is is shortened you know engagement and rapport or strength and and the brief intervention is brought in at that time because of the third reason which is as I've said people are busy they're going places that's been my experience a very little interest in engaging in long therapy sessions so our task is to develop brief interventions that address some other key issues the holistic nature of the way people experience social emotional well-being as well as the the language and literacy issues so I might direct us to those slides now if you like Dana because this gives an example of one approach which is we have been using and gaining a lot of feedback in terms of this approach and what we tried to do with this brief intervention which has four steps I'll only show the first two what we tried to do was to also help non-indigenous practitioners without any cultural competence training to gently enter a therapeutic session and so there's the first step after opening the door after moving into the session and those other tips that we've made the first step is beginning to have a conversation about family and we have this approach in this electronic version this is a an app that can be downloaded for free and we'll also show that the the written here plans that also follow the same sequence so taking time sometimes people don't get beyond the people in the first session and we've had people working forensic mental health services and say okay well it's as far as the got for now but for those of us you know clinicians all of us can recognize that's actually a really good place to begin treatment you'll have already developed a support network brought it to life and your one step even if that was all you did for most of it that that begins to address a sense of belonging and connections this is a low intensity cognitive behavioral therapy intervention that I'm describing that's the first step the second step is the next slide and this is the way we've approached that next step of gathering information avoiding asking different questions if we can avoiding sitting face to face sitting side by side and prompting with options and this is where it's your story not about you know asking each question one after the other the actually it's about saying are any of these things strengths for you and I'll just mention only after that positive you know enjoyable beginning where we hope that some trust and rapport has built as well as there's getting much stronger sense of what's going on for that person where we then talk about worries and what we do in this brief intervention is set lifestyle goals what's safe about it is that we're looking at the priorities from through the lens of that person if you follow this this path the goals they choose will be their goals related to their strengths and their worries that's usually do more of what keeps me strong less of what's taking my worries what's giving me worries so what we've developed is there is a brief intervention I've mentioned it's a low intensity cognitive behavioral therapy intervention and it's one that you can deliver opportunistically on the run but it also is quite a thorough assessment and will grow as you as rapport develops and you see that person that child or that family again so you mentioned individual and group yes you can do it in a group setting as well we don't need to be guided necessarily by the pictures the approach by self-stands which is let's ensure that we're hearing from that person what their strengths are first before the worries and setting up goals for change that they're setting absolutely and thank you so much Tisha and there was a some final resources that I also know that you wanted to share which I'll bring up too as well yes thanks that's the the written version so that says stay strong plan there and the first two slides were from the stay strong app so that evolved from those initial five years that I was talking about earlier and and now is one of the ways in which we train people around the country in delivering a brief intervention and getting it in there nice and quickly so people don't go away and with nothing great thank you so much to both of you it's it's surprising how fast the time has gone tonight so I've got one more question and now I want to have have you both have a chance to reflect give any final reflections that you want to give the people but a big question first to both of you so essentially I mean you've talked about so many different things tonight about how we engage self-determination cultural considerations approaches strategies all sorts of ways in which we can support connection with culture and have cultural consideration and so much of that takes time and means it's in relationship etc I want to ask a big question that I think will come up for people because they're in organizations that are busy they've got pressures all over the place um so I wonder you know from both of your experiences and I wonder if Adele you could start first what are the conditions required in organizations and systems to genuinely embed these ways of working from what you and Trisha have spoken about tonight just trying to think what's uh you know Dana what's another term other than condition to one of the kinds of things yeah yeah totally um what are the kinds of funding requirements policy management structures ways of being in an organization that is really going to support this kind of work genuinely support this kind of work yeah look I think first and foremost is that leadership from the top kind of acknowledging that um you know the need to respond to and prioritize uh Aboriginal and Torres Strait Islander kind of issues um children's needs um depending on what kind of service you are obviously you know without understanding and knowing and and doing a mapping of you know each service in understanding the context in which that organization itself comes from um we've got um you know we've we've got some really great um changes and and movements that have happened where we've seen a real kind of promotion and push for not Aboriginal services where they haven't had the capacity yet in terms of having either an internal Aboriginal engagement strategy and increasing you know the number of of Indigenous people as part of their workforce and and kind of meeting those markers um where they you know could engage and and make that you know established relationship and genuine partnerships with other organizations in the area um there's there's uh you know things such as uh we we mentioned a reconciliation action plan um you know reps exist not just for organizations who who have prioritized you know Aboriginal and Torres Strait Islander kind of issues at the fore but a genuine interest from organizations who actually just want to do better in in Australian society in responding more broadly to you know supporting culture and and identity and that kind of stuff other things I mean you know we we at Snake um you know some of your some of the participants may have been privy to and and you know heard kind of recent announcements um several months ago uh about a partnership between Snake and Life Without Barriers and and Life Without Barriers as a major you know non-Indigenous NGO have made the commitment that intent you know by 10 years they will have transferred um all of the Indigenous kind of specific services and and supports over to Aboriginal community controlled organizations um and part of that is is again tying it back to self-determination um it's around you know looking at how do we better address kind of the broader social determinants um and so we've got efforts like that that are happening right now um and and there's been a real shift um I think positively um that's showing you know that the things can be done if if people are willing to uh to consider change and part of that change is is you know and thinking about funding streams and and that kind of stuff uh you know a lot of us are still working with governments and advocating to ensure that they you know uh make sure that they are given sound advice from Aboriginal leadership in terms of what happens around funding um allocations around you know new policy and program development um and you know the know-how's there um you know we've had an absolute you know the number of Aboriginal and social and academics we have and and you know people who are kind of at the fore of making these decisions um is is brilliant and and we should be making you know better use of um and certainly considering more inclusion of as well um and I think part of it is you know making sure that we're at the table um you know it has to be it has if it's about us it has to be with us all right thank you Adele and have it you Tricia um what are the sorts of conditions system structures processes that you think need to be there for to truly embed this kind of work from your learning well there needs to be the aspiration from the organization and certainly the resources around the wrap planning are fantastic and we've talked about the elements within an organization that shows that it's trying so most of them have come out you know you're recruiting you're aiming to recruit and retain an Aboriginal and Torres Strait Island workforce you're aiming to have leaders and governance inclusive of Aboriginal people you want firm strong lasting collaborations with Aboriginal services that are relevant to your organization and you want your policies and your procedures to to weed out anything that's discriminatory and to be committed to anti-discrimination commit the organization to cultural learning and ensure that you try aspiring to a culturally competent workforce by some of those other obvious um uh elements that we've talked about having your organization with local artwork we're celebrating key key moments acknowledging key elements of that of that important calendar that we've talked about now one of the ways to help the organization is to because you mentioned how busy we all are well you know the advantages there's a lot of rushing around being busy because we're not doing the job very well and I mentioned you know back when Aboriginal people were coming in from remote communities and coming in again the next month and coming in again the next month if we actually manage our services create cultural safety develop our our therapies so that they're carefully carefully crafted and tailored we save ourselves time so um I just wanted to add to all of what Adele said just those other right thank you so much for sure and now we're coming really soon to closing tonight and I just wanted to give each of you an opportunity you've got about 30 seconds each to really kind of give you know a key message that you want to leave people with tonight out of all of the things that you spoke about Adele firstly is there a you know a key sentence a key sort of messages that you'd like to give um in closing tonight okay I think it's it's one of support um supporting understand you know support and acknowledging that it's it's um it's it's not going to come automatically um you know someone's ability to to engage effectively and and be able to communicate and you know establish rapport and trust and and that respect with with an Aboriginal person um but I really love what Trisha said is you know um find a mentor and and grab hold of them um one of the things that I I like and I often tell people is look there's um there's no stupid question I'd rather you ask me something um you know in a safe and secure environment and and I then be able to respond in a way that you know helps your learning and and you know kind of helps you on on that journey um rather than you kind of continuing and and you know keeping that to yourselves and assuming things and and that's the other thing never never assume anything always ask absolutely absolutely thank you so much Adele and Trisha is a final message that you'd like to give before we close move towards closing well I think I'll reinforce the importance of perhaps shifting the way we usually work it's very difficult as a clinician to do that but to aspire to shift into a strength-based approach to shift into a sharing and a collaboration and present presentation of the menu of options and move away from our our training which tells us that we do we must know and we must decide and we must set the goals so that's the first one the second one is to just commit to a culture to learning to learning about culture and building our own cultural competence it's just a journey wonderful well thank you so much Trisha and Adele for tonight it's been a real delight to be facilitating and and learning and hearing from both of you so thanks again to both of you thank you Donna thanks Dana thanks Adele and thank you all tonight for participating so um you know please ensure that you complete the feedback survey before you log out click the yellow speech bubble icon on the top top right hand corner of your screen to open the survey your statements of attendance first webinar will be issued within four to six weeks and each participant will be sent a link of the recording if you missed anything tonight so you'll be able to um have a look back on that there's a range of resources and further reading i won't go through that tonight except to say that there's lots of stuff for you to have a look at and of course remember the future webinars that are coming up soon the webinar was quote code produced by mhpn then the emerging minds for the emerging minds national workforce center for child mental health project the nwcc mh is funded by the australian government department of health under the national support for child and youth mental health program would you like to continue this discussion well you can or perhaps start discussing issues of local relevance mhpn offer project offers are available to help you established or join these networks face-to-face or online there are 373 around the country as well as online networks visit your online map to find out which networks are close to you at mhpn.org.au or contact Jackie O'Loughlin at networks at mhpn.org.au and finally before i close i'd like to acknowledge the consumers and carers who have lived with mental illness in the past and those who continue to live with mental illness in the present thank you to everyone for your participation this evening have a good and wonderful and restful night thank you