The social and cultural diversity and the wide geographical dispersion of Aboriginal and Torres Strait Islander communities across Australia highlights the need for consistent standards of practice for services and interventions and the capacity to assure high quality in programs of activity. There are three major components to the Strategy: 1) Measures to improve Aboriginal and Torres Strait Islander participation in the workforce through access to training and qualifications at all levels; 2) Implementing quality controls to strengthen uptake and embedding of preventive activity in primary health care and other service sectors; and 3) Strengthening the role of evaluation to support quality implementation of programs and to evaluate their outcomes.
Outcome 6.1 There are comprehensive plans to develop participation of Aboriginal and Torres Strait Islander peoples in the suicide prevention and wellbeing workforce.
- Issue: The need for a systematic approach to building the Aboriginal and Torres Strait Islander wellbeing workforce and to improving specific skills in suicide prevention and social and emotional wellbeing was consistently emphasised at the forums. The approach needs to be cross-sectoral with regard to workforces in early childhood, educational services, health care, child protection therapeutic services, police and other sectors. Special provision should be made for Aboriginal and Torres Strait Islander community members unable to access training in universities or colleges in city centres.
Outcome 6.2 Standards are developed for community engagement and cultural awareness in wellbeing services and for early intervention for Aboriginal and Torres Strait Islander peoples, families and communities.
- Issue: Guidelines, resources and information about specific successful models of culturally appropriate engagement are needed. Concerns that a checklist approach to cultural competence may be superficial and counter-productive need to be met by trial and rigorous evaluation of culturally adapted practice models and training approaches with and for Aboriginal and Torres Strait Islander personnel.
Outcome 6.3 Programs are evaluated and there is quality support for implementation.
- Issue: Provision for evaluation can be significantly improved in funding arrangements under state and Commonwealth contracts. There are currently very few evaluations conducted that contribute to the evidence base in any way. Aboriginal and Torres Strait Islander community services benefit from evaluations of programs that demonstrate their effectiveness and that provide information for practice development, policy and planning.
Outcome 6.4 Suicide prevention principles are embedded in systems of quality improvement for social and emotional wellbeing and mental health care.
- Current guidelines and protocols for mental health care, hospital emergency services and other areas of social and emotional wellbeing practice can be improved in terms of their specificity for suicide prevention and appropriateness for Aboriginal and Torres Strait Islander peoples. There is a need to encourage uptake of current Medicare items where possible for mental health and social and emotional wellbeing assessment in the Indigenous Health Check through training and audit. There is a need to embed suicide prevention practices in existing continuous quality improvement processes.
|Outcome 6.1 There are comprehensive plans to develop and support the participation of Aboriginal and Torres Strait Islander peoples in the suicide prevention and wellbeing workforce such as nurses and counsellors||i. Work towards a coordinated approach to Aboriginal and Torres Strait Islander workforce development across sectors and levels of government|
ii. Review pathways to recruitment and training to enhance access to appropriate courses for community members
iii. Work with Aboriginal and Torres Strait Islander training organisations, the Aboriginal and Torres Strait Islander VET sector and other organisations to build access to appropriate training options
iv. Develop funding options to secure Aboriginal and Torres Strait Islander input into development of training resources
|Outcome 6.2 Standards are developed for community engagement and cultural awareness in wellbeing services and for early intervention for Aboriginal and Torres Strait Islander peoples, families and communities||i. Build evidence to support guidelines for community engagement and culturally responsive practice through evaluation of cultural protocols in training and practice|
ii. Disseminate information on best practice models, including manuals, guidelines and resources for training and service delivery
|Outcome 6.3 Programs are evaluated and there is quality support for program implementation||i. Ensure that there is provision for evaluation in funded suicide prevention programs|
ii. Support specific partnerships between research organisations and the Aboriginal and Torres Strait Islander community sector to evaluate program implementation and outcomes
iii. Use evaluation to build systems of quality improvement for suicide prevention in health care, child and family services, education and other services.
|Outcome 6.4 Suicide prevention principles are embedded in systems of quality improvement for social and emotional wellbeing and mental health care||ii. Where possible encourage through current programs including general practitioners and other clinicians to increase provision of mental health assessments and treatments through training and quality improvement strategies|
ii. While there are limitations in the Medicare Benefits Schedule data as a measure of provision of services for Aboriginal and Torres Strait Islander clients, examine the possibility of using the Medicare Benefits Schedule to monitor access to general practitioners, psychiatrists and psychologists, and the flow-on effects of these services to Aboriginal and Torres Strait Islander wellbeing services through referral and other links.
iii. Work with the Aboriginal and Torres Strait Islander community-controlled healthcare sector to ensure that suicide and self-harm risk assessment are incorporated in continuous quality improvement systems for child, youth and adult mental health services.