A scan might have found the cancer now killing Daniel van Roo. Instead his doctor gave him 50 STI tests, which van Roo believes was because he is gay.If I hadn’t taken action and if I hadn’t seen a doctor then, you know, then where I am is just where I am. But because I did do those things, I am probably going to be upset about it when I am laying in the hospital bed at the end.
Australia’s Indigenous youth suicide crisis
In this story
It was at a community meeting in Broome recently that concerned leaders reported the emergence of a new game in school playgrounds, alongside the usual things played at recess elsewhere in the country. To understand the game you need only understand its name, as children call it to each other: “Let’s play hangsies.”
The chilling normalisation of suicide among Indigenous children in Australia’s north-west is a symptom of a crisis getting worse not better.
The death of a 10-year-old girl in March, apparently by her own hand, blanketed the tiny, devoutly Christian community of Looma, south of Derby, in grief. It also sent a jolt of horror and shame across the country.
How could a child form the intent to end her own life, let alone complete the act? How could a little girl have lost all hope when she should have a whole life to live? What went so appallingly wrong?
She came from the community of Kalumburu, north-west of Kununurra, which sadly has a documented reputation for child sexual abuse. In their short lives, she and her five-year-old brother had moved regularly, living with extended family. Their father is in jail awaiting trial on family violence charges and their mother is permanently disabled from years of repeated bashings. Their 12-year-old half-sister killed herself three years ago.
The children had been staying with their aunt in Looma, population in the hundreds, and for about four weeks had been attending the vibrant Looma Remote Community School, winner of a Western Australian Premier’s Excellence in Aboriginal Education Award last year.
On Sunday, March 6, the little girl took her own life. West Australian coroner Ros Fogliani will try to find out why. After a preliminary examination, Fogliani has decided to investigate a group of suspected suicide cases together. Her office can’t say yet how many or when an inquiry will begin. “The Coroners Court is making every effort to progress the matter as soon as possible,” a spokeswoman says.
Sources in the north-west have told The Saturday Paper the inquiry is likely to examine up to 11 deaths and begin hearings in October.
The previous state coroner, Alastair Hope, conducted a similar investigation in 2007 at the urging of campaigners including Wes Morris from the Kimberley Aboriginal Law and Culture Centre.
Of the 27 recommendations he made, Morris says, only one has been taken up, relating to mental health.
On Thursday, Morris and a delegation of experts met the directors of the WA health and Aboriginal affairs departments and the mental health commission to discuss the report of a federally funded evaluation project that held roundtable talks in the Kimberley last year, and the locally developed Yiriman suicide-prevention program, which Morris says received no ongoing state government support.
One in four Indigenous suicides in Australia occurs in WA. But much investment had gone into clinical approaches, ignoring the local advice, Morris says. The incidence of Indigenous suicide in the Kimberley–Pilbara region is the worst in the country, closely followed by Far North Queensland.
Among those trying to keep their children from harm, the sense of urgency is palpable. So is the sense of disappointment and disempowerment, of unmet hopes and expectations and of policymakers going around and around as governments are voted in and out.
“There are many people in the bureaucracy and in government but nothing effective happens,” says Rod Little, the co-chairman of the National Congress of Australia’s First Peoples. “Nothing effective happens.”
The statistics are horrifying. Some experts believe up to 25 Indigenous people have suicided in WA since November last year.
Gerry Georgatos, a suicide-prevention researcher with the Institute of Social Justice and Human Rights, counts at least 19 suspected cases, many of them in the Kimberley. Georgatos says the Indigenous people of Australia’s Top End have among the highest suicide rate in the world. The little girl at Looma is not the youngest to take her own life.
“I’m aware of [children] as young as eight or nine,” Georgatos says.
Among those involved locally in trying to tackle the problem, the starting point is always the same: empowerment.
Paediatrician and 2001 Young Australian of the Year, Dr James Fitzpatrick, a foetal alcohol spectrum disorder specialist, sets out the factors contributing to such terrible suicide statistics, starting with the earliest stages of a child’s development.
The scenario goes like this.
A young woman becomes pregnant. Because she is in a high-stress family and community environment, she has stress hormones in her blood. There may be violence in her family, or poverty, or both. Her community may lack employment opportunities, with a high reliance on welfare and a creeping sense of hopelessness. She may abuse alcohol or other substances to escape the stress.
Any of these factors – let alone the combination of all – can have a devastating effect on the unborn child growing within her. The stress hormones and other substances in her blood can predispose her child to diseases or mental health problems with a lifelong impact.
The child may well be born into a loving family network with a strong traditional kinship system. But at the same time, the immediate care environment may be, as Fitzpatrick puts it, “unstructured and chaotic”, with the child lacking the sense of being safe and not having medical and nutritional needs met or behavioural boundaries set.
This affects the development of neural pathways, including the capacity to understand cause and effect and ability to reason. Because of family breakdown or dysfunction, the child may not experience secure attachments early in life.
In these situations, he or she also becomes highly stressed and affected by those same hormones directly. Poor health ensues, with the onset of chronic infections that impair life development. When the child reaches school age, he or she may attend sporadically or not at all, without having learnt behavioural skills such as how to sit still and concentrate.
When school becomes more challenging, the stress gets worse. Fitzpatrick has found girls tend to withdraw, become anxious and internalise their stress, while boys often act out and are aggressive. The children can fail to learn to “self-regulate” – to develop appropriate responses to challenging situations – resulting in wilful behaviour, poor impulse control and poor judgement. They can end up in contact with the law.
Then someone does something upsetting – takes their phone, mocks or bullies them, fails to include them in a group activity or refuses a minor request – and a young person’s response can be out of all proportion to the offence. “You go and burn something or break something or hurt someone,” Fitzpatrick says. “Or kill yourself.”
It seems an unbelievable response to a minor social conflict. Yet in his 2007 investigations, Alastair Hope found such sequences of events time and time again.
Puberty and adolescence exacerbate these problems as life becomes more complex, and the risk of self-harm intensifies. And the cycle goes on.
James Fitzpatrick is in no doubt that there is a solution. But it requires hard decisions and hard work. “The bleeding-heart approach of always explaining away Aboriginal youth suicide and Aboriginal malady by talking about the real but historical trauma of these communities doesn’t get us anywhere,” he says. “The thing that gets us on the road out of hell is [communities] saying, ‘We own it, we have to put our hands up, name it and work really hard to get ourselves out of here.’ It’s about accountability and ownership of the problem and responsibility.”
He says communities are taking it on. But the structural support has to be there to help them. “It’s going to need to be hit with a large sledgehammer,” he says. “It’s absolutely possible [to fix the problem]. It needs a seismic, strategic and long-term approach.”
By long term, he means a decade or two of hard money and policy commitment, with a component for evaluation as the work goes along and the capacity to adjust if need be. And, he says, communities need “enterprise” to provide opportunity for meaningful work.
Others working to tackle these problems locally agree communities must take responsibility and address their situation, with government consultation and support. But two recent reports examining aspects of federal policy suggest the opposite of that is happening.
A senate inquiry recently probed the Indigenous Advancement Strategy – the Abbott government’s centralisation of Indigenous affairs management within the Department of Prime Minister and Cabinet. Its report reveals the change that saw 150 funding streams collapsed into just five, without consulting or adequately considering the impact on Indigenous organisations delivering community-level services, has added layers of regulation that have affected their ability to apply for funding and do their work. It saved half a billion dollars in the 2014 budget.
The department’s then associate secretary for Indigenous affairs, Liza Carroll, agreed there was too little advance consultation, saying it was constrained by the fact budget measures are confidential. “We probably had underestimated the amount of effort that we are now realising was needed upfront…” she told the inquiry. “Even we had underestimated the breadth and difficulty for a number of organisations.”
Community leaders say non-consultation contributes to the sense of disillusionment. “They’re saying, ‘We’re not asking for much,’ ” Rod Little says. “ ‘We’re asking for support to help us grow and sustain our community. We’re never really asked about the programs we want.’ ”
Gerry Georgatos agrees. “They want to be heard. But the listening isn’t actually happening.”
A separate report by the often-ignored parliamentary joint committee on human rights into the Stronger Futures policy finds aspects of that are having a detrimental effect.
The policy follows the Howard government’s 2007 Northern Territory intervention, now being rolled out around the country. But the report finds compulsory income management is ineffective and should instead be voluntary or target specific individuals and families with identified problems of substance abuse, gambling or neglect.
The chairman of the Prime Minister’s Indigenous Advisory Council, Warren Mundine, says the policy is a failure. “In regard to resolving the issues that it was set out to do in relation to child abuse and suicide, you’ve got to say it’s failed,” Mundine told The Saturday Paper. “We’ve got to sit down with Indigenous leaders on the ground and say, ‘How do we deal with this?’ ”
Rod Little believes there is too much of what he calls “rhetoric policy” – dreamt up in a central office far from the heart of the problem, looking good on paper with poor practical application. “The draconian measures and the rhetoric policy do not work,” he says. “So why do they keep doing it? Where is the support to enable [people] to manage their own affairs?”
To try to get closer to the ground, the federally funded Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project has been examining existing programs to establish what is and isn’t working. It has been running roundtable discussions among demographic groups and in towns where there have been high rates of suicide.
At a meeting on youth suicide in mid-March, 13 young representatives discussed their experiences. “Loss and grief are the norm in our communities,” one participant said. “Where there is one death in our communities, it is followed by another one soon after and another one and another one. The grief just carries on. The sense of loss is ongoing.”
Referring to Australian Institute of Health and Welfare statistics, the youth roundtable report says one in three deaths among Indigenous people aged 15-24 is by suicide.
It says Indigenous children aged 14 and under are eight times more likely to die that way than non-Indigenous children. And it reaches an almost incomprehensible conclusion: “Suicide is the leading cause of death for this age group among Aboriginal and Torres Strait Islander children.”
Another of the project’s roundtable meetings was held in the Kimberly last August. The day before it convened, there was another local death. The meeting opened with a minute’s silence.
The resulting report made clear recommendations. First, it said it was “essential to have culturally appropriate, targeted suicide prevention strategies that identify individuals, families and communities at higher risk through levels and expressions of disadvantage.” Second, it emphasised the need to co-ordinate preventive approaches in health, education, justice, child and family services, child protection and housing. And third, it recommended building the evidence base.
A spokesman for Indigenous Affairs Minister Nigel Scullion says the government will carefully consider the coming final report “and respond to it in due course”.
An interim report, received late last year, highlighted the summer school-holiday period between November and February as a critical time, when the suicide risk peaks.
“The minister acted on this advice and funded a $1 million critical response initiative to respond to suicides and their triggers by co-ordinating existing services,” the spokesman says. “The initiative does not replace existing suicide-prevention services; it supports their more-effective delivery.”
The program’s preventive component is being trialled in the Kimberley, with focus on “a co-ordinated and family-centric model of care” which Indigenous-led services are co-ordinating.
The minister defends the Indigenous Advancement Strategy and its new funding arrangements. He says 45 per cent of organisations applying for grants through the program were Indigenous and they received 55 per cent of funding, up from 30 per cent previously.
“For the first time ever,” the spokesman says, “the government has a clear picture about where taxpayers’ money in the Indigenous Affairs portfolio is being spent – and what outcomes we are expecting from this investment.”
This week, at the urging of Kimberley MP Josie Farrer, the WA parliament established an inquiry into Indigenous youth suicides in WA.
It will look at the fate of previous inquiries’ recommendations and issues including resourcing, service provision and the effectiveness of current strategies and report on November 17.
Some are demanding more. “We have to take control of this,” Warren Mundine says. “We have to. Because government’s never going to fix it.”
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This article was first published in the print edition of The Saturday Paper on Apr 2, 2016 as "Black youth suicide crisis".
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