I write as a GP who provides primary care to Indigenous people in an Aboriginal Controlled Health facility – Jullums Lismore Aboriginal Medical Service.
One of our roles at Jullums is to provide health services to residents from a diversionary NSW Corrective Services facility called Balund-a.
To gain more skill and understanding for this role I recently attended the National Indigenous Incarceration Conference (NIIC) held at Kingscliff. It was well attended with mainly Aboriginal and Torres Strait Islander (ATSI) speakers and delegates. For me it was a time to listen, learn and reflect.
The figures on ATSI incarceration are alarming. To quote Labor Senator Patrick Dodson: “Indigenous people are more likely to come to the attention of the police, Indigenous people who come to the attention of police are more likely to be arrested and charged. Indigenous people who are charged are more likely to go to court. Indigenous people who appear in court are more likely to go to jail. Indigenous youth now comprise over 50% of juveniles in detention. The statistics speak for themselves and the cold fact remains an indictment on all of us.”
It seems the ‘tough on crime’ approach is failing. Indigenous youth now comprise over 50% of juveniles in detention
Since 2004, the number of Aboriginal Australians in custody has increased by 88% compared to 28% for non-Aboriginal Australians. Australia is heading towards one in two of the prison population comprising Aboriginal prisoners by 2020. In 1992, the ratio was one in seven.
At the conclusion of the NIIC two recommendations were passed:
- A national review of out-of-home care – acknowledging the high rate of removal of ATSI children into out-of-home care and the inherent links with juvenile justice and adult incarceration. The Commonwealth Government should establish a national inquiry into child protection laws and processes affecting ATSI children.
This has been taken directly from Pathways to Justice – an inquiry into the incarceration rate of ATSI peoples published by the Australian Law Reforms Commission. The inquiry’s conclusion was basically to promote justice reinvestment through redirection of resources from incarceration to prevention, rehabilitation and support to reduce reoffending and the long term cost of incarceration.
It seems the ‘tough on crime’ approach is failing and building more jails is not the answer. Other countries such as in those in Scandinavia are getting much better results for much less cost than Australia. They also have an Indigenous community namely the Sami people.
- Raise the age of criminal responsibility from 10 to 15 years.
This is in line with the growing momentum for change and to bring us into line with other countries. The European average is 14. Other reasons cited are the protection of children’s rights, the limited ability of doli incapax (of 10-14 year olds not knowing their behaviour is wrong rather than just being mischievous) and issues of mental illness and cognitive impairment.
A low age of criminal responsibility adversely affects Indigenous children who comprise the majority of children under 14 years who come before youth courts and are sentenced to detention or community based sanction.
Finally, the NIIC concluded with a strong and emotional endorsement of the Uluru Statement from the Heart.
This has also been endorsed by the AMA who lodged a submission to the Joint Select Committee on Constitutional Recognition. RACGP also recently endorsed the Uluru statement.
The Uluru statement from the Heart has three main calls: to have a First Nations voice enshrined in the Australian Constitution; Makarrata which means ‘bring the community together after a struggle’; and truth telling of the sixty millennia history of Australia.
There are many health reasons alone why this statement is important. An article on Croakey website stated:
“Paying attention to the social determinants of health is particularly important if we are to close the health and life expectancy gap between Indigenous and non-Indigenous Australians. In particular, racism, social exclusion, disempowerment and intergenerational trauma have been identified as important factors that need to be addressed before we will see real improvements in the lives and health of ATSI people.”
They put five reasons forward why The Uluru Statement from the Heart should be endorsed on health grounds alone. These are well worth reading.
Overall I was enlightened by this conference and have a better understanding of the challenges before us. The self-determination message from speakers was loud and clear. There is so much we non-Indigenous health professionals can do to become more culturally aware of the serious plight of our Indigenous community and support them both with our clinical skills and politically.