13 October 2022

By Leilani Darwin, Director, Mind Australia. Leilani is a proud Quandamooka woman, whose ancestral home is Stradbroke Island.

When you are somebody who happens to work nationally across both the mental health and suicide prevention sectors you would hope that finding help would be possible. What if I told you that it is, in fact, the complete opposite?

Despite my knowledge and connections, my own experience with seeking help has been far from a positive process. In fact, it has been a damaging, frustrating, painful space that has left me and my loved one completely broken by the system.

Why is this of relevance? Quite frankly because, if these are my experiences, then it completely overwhelms me to imagine what it is like for everyday Australians, and what it is like for other First Nations People, who have additional challenges and barriers to overcome.

Racism and exclusion in healthcare are real

You see, the reality is that we do experience racism, and we are judged and treated differently to others in the healthcare system. These are both my personal experiences, and the experiences that others from across the country have bravely shared with me, backed by research findings from well-established authors.

Earlier this year, following a change in our nation’s leadership, I wrote a piece as part of the CEO update for Mental Health Australia. In that update I reflected that We (the First Nations People of Australia) have seen many things progress positively for our people.

This includes progress towards constitutional reform and recognition, removal of mandated cashless debit cards, forecasted improvements in access to affordable childcare for our young people, and many other positive reform activities.

The addition of Social and Emotional Wellbeing to the Close the Gap Strategy will provide a clear pathway to accountability of how we address and respond to mental distress and our service/support pathways.
However, exclusion still exists across the system.

For decades we have seen non-Indigenous service providers continue to be funded to provide mental health and suicide prevention supports and programs, often with the clear exclusion of self-determined and culturally safe and appropriate responses.

In both my professional and personal lives, I’ve experienced many conversations that have not just had a clear power imbalance, but have also embodied a very paternalistic, arrogant approach. Ultimately, the lack of cultural pathways and considerations of both safety and treatment options, remains in a desperate state of chaos.

The human impacts of systemic failure

In recent times I’ve been supporting my teenage daughter, and I can recall key moments when the systemic failings reflected in our experiences broke her.

Early on, her encounter with a doctor in the emergency department saw her in tears, unwilling to continue engaging and being shamed for her experiences and expressions.

I also felt exclusion and shame when I was questioned about my ability to keep my daughter safe, after I queried the lack of response or support for someone who was clearly suicidal and wanted to die, yet was sent home with the full responsibility on her family to keep her alive and safe.

During the times of hospitalisations and external support I was not once offered support for my own mental health and wellbeing despite being clearly distressed, and at a loss as to what I could do to keep her safe.

When a young person who has yet to be diagnosed mental illness, trauma and suicidality is told on several occasions that certain actions and supports will be provided, and then those things are not forthcoming, it damages any ongoing engagement.

And at other times, when that young person seeks help from a phone service, only to be hung up on when they are hyperventilating and unable to respond, this results in a genuine belief that help seeking will be met by no help, and that there is no hope of ever getting the right help and support, or of things getting better.

Compounding impacts

These experiences are not uncommon, but they have compounding impacts on Indigenous peoples. Some non-Indigenous people are quick to say that happens to everyone. However, in those statements there is an explicit non-valuing of how and why as First Nations people our experiences are different.

For example, when you discover your child has had a suicide attempt and a severe allergic reaction, you weigh everything up and know that it’s quicker for you to drive them to the emergency department than to call an ambulance.

Upon arrival in a packed waiting room, your daughter is directed to sit on the weight determining chair, and almost falls to the ground. The staff’s response is to berate and criticise you for not calling emergency services, who could have administered early healthcare interventions.

I’m not saying that I don’t understand this perspective because I know how overworked and under resourced our hospital and health systems are. What I’m saying is that not only was it shameful for me, but that when I looked down and saw the Aboriginal designed shirt I was wearing, it hit differently.

It also wasn’t helpful that time was being wasted to school me on what I should have done, while my child was about to pass out in the emergency waiting room.

The lack of empathy shown to my daughter and I continued, and I also observed another Aboriginal person who had clearly had an attempt being spoken down to with such an air of disdain and inconvenience that it took everything in me not to speak up on their behalf – but you see that wasn’t my role, nor was it going to address the underlying issues, or help my daughter to receive appropriate care.

With these examples being only a few of the many I and others have experienced, it’s an important time for us all to reflect on what is that we can do to make the system and services better so that others don’t have to have similar experiences.

Building lived experiences into mental health reform

During COVID our communities brought to light the struggles and challenges with mental illness and the stigma around accessing support. We are yet to see or understand what the true impacts have been and the ongoing effects of this global pandemic.

I’m asking for us all to come together to ensure that the lived and living experiences of everyone are elevated and embedded not just in future responses, but also in ensuring that all aspects of mental health reform, policies and practices are built on these experiences.

We need Federal Health Minister Mark Butler and Shadow Minister Emma McBride to commit to working with us and walking alongside us.

For this is one thing that I am certain of: if we don’t immediately address the barriers, challenges and lack of culturally led and appropriate systems responses and pathways, then our future generations will continue to be negatively impacted.

The lack of support and understanding is further exacerbated by our experiences of powerlessness and injustice, in ultimately just tirelessly working to keep our loved ones alive. I can’t and won’t stand by with idle hands and mind when we know the solutions to address the barriers and challenges.

This article was originally published on Croakey’s website as part of the Speaking Our Minds series on 13 October 2022. Find the Croakey story here.

Leilani is a proud Quandamooka woman and Founder/CEO of First Nations Co. She is also the Director of Aboriginal and Torres Strait Islander Strategy at the Black Dog Institute, driving their program to be a trusted partner to Aboriginal and Torres Strait Islander communities to address suicide prevention and mental health.

If this article raises concerns for you, please call Lifeline on 13 11 14. Aboriginal and Torres Straits Islanders can also call 13 YARN (13 92 76) a 24/7 national crisis support telephone service staffed by Aboriginal and Torres Strait Islander peoples  
If you would like more information, please contact us via Mind Connect or phone: 1300 286 463