Two recent projects in northern New South Wales have affirmed that communities know best when it comes to delivering community-led health initiatives, especially in Aboriginal and Torres Strait Islander communities.
Inequities in the social determinants of health mean that Aboriginal and Torres Strait Islander people do not have the same opportunities to be as healthy as non-Indigenous Australians, due to a lack of culturally appropriate health services, including primary health care.
The Malpa Institute believes that this situation can be improved through more meaningful, culturally appropriate preventative health programs, such as its ‘Dhalayi Doctors’ (Young Doctors) program. It focusses on improving locally identified primary health care and wellbeing issues within Aboriginal and Torres Strait Islander communities.
A $20,000 grant from the Foundation for Rural & Regional Renewal's (FRRR) Innovation for Community Impact program assisted The Malpa Institute to deliver the Young Doctors program – known as Dhalayi Doctors in the local Dunghutti Country language - to students at six primary schools in Kempsey in the New South Wales Mid North Coast region.
The program is designed and run by local Elders, respected community members and is supported by health workers. It aims to boost young people's cultural identity and enhance their access to health services pathways within their community. This early intervention approach is intended to raise awareness of Western medicine and healthcare, at the same time as strengthening connections with culture and traditional bush medicine.
The Innovation for Community Impact grant, which was funded by the Snow Foundation, nib foundation, Flannery Foundation, Katz Family Foundation, Myer Family Company, Doc Ross Foundation, Vincent Fairfax Family Foundation, Sally Foundation, Greater Charitable Foundation and CAGES Foundation, assisted Malpa to deliver its Young Doctors programs to 120 primary students over one year. The 90-minute sessions include activities that support local health priorities, including mental health, hygiene, nutrition, sight and hearing. The sessions created a safe and accepting environment for students to have productive and engaging educational experiences. It also means that there are now young healthy-living ambassadors at six Kempsey schools equipped to help strengthen their communities.
As one mother explained, it was a very engaging and popular program. Her son had been having issues going to school, and one morning he didn't want to go at all. Then he realised it was Dhalayi Doctor's day and quickly got dressed.
"It's the only day I want to go to school 'cause I know I'll be going to Dhalayi Doctors," he said.
In another case, Rural and Remote Mental Health Ltd identified that the Aboriginal and Torres Strait Islander community in Armidale NSW faced significant challenges. This included unemployment, substance abuse, barriers to health services and education, and a higher risk of and rates of mental illness. They also recognised that many community members didn't trust the local mainstream service providers, increasing their reluctance to seek help.
To promote better mental health in Armidale, Rural and Remote Mental Health received a $5,000 grant from FRRR, via the Domino's Give for Good program, to implement mental health training called Deadly Thinking. Twenty-six community leaders, helpers and Elders attended a two-day train-the-trainer program. A further seven people then participated in a community workshop.
The outcomes of the workshop and training sessions were staggeringly positive. Every participant in both the train-the-trainer course and community workshop said the key message was that 'it helped to have a yarn about mental health issues', and they understood that 'mental health issues are very common'.
Feedback surveys suggest that the Deadly Thinking program was effective in reducing mental health stigma by providing targeted and comprehensive information on mental ill-health. Participants reported increased confidence discussing emotional and social wellbeing, and the knowledge to better support their community members. Participants appreciated tailored information and resources.
The Foundation for Rural & Regional Renewal continues to support these kinds of initiatives through its grant programs and welcomes applications from groups around the country.