Health and wellbeing

Our shared commitment

Self-determining, healthy and safe Aboriginal people and communities.

Holistic approaches to Aboriginal health and wellbeing are critical to improving outcomes. This includes not only considering the physical, mental and social determinants of Aboriginal health, wellbeing and safety, but also the cultural determinants, such as connection to culture and Country. While many Aboriginal Victorians report good health, health inequities remain.

Together, government service providers, Aboriginal organisations and communities must take significant steps to ensure that all Aboriginal Victorians have access to high-quality, culturally safe and responsive health care services. Improving overall health outcomes and having a good quality of life is a basic necessity to ensure all Victorian Aboriginal communities can thrive.

Goal 11: Aboriginal Victorians enjoy health and longevity

Overview

Measures under Goal 11 have worsened.

While Aboriginal people are living longer, rates of cancer, hospitalisations for potentially preventable causes, and emergency department presentations for alcohol or drug-related harm remain higher for Aboriginal Victorians compared to their non-Aboriginal peers.⁷ In many cases, these rates have increased. While the increased uptake of specialist alcohol and other drug treatment services suggests these services are becoming more accessible, it is clear there is still work to be done to improve outcomes.

Several systemic issues may have contributed to these outcomes, including:

• funding and workforce issues characterised by limited core funding for Aboriginal Community Controlled Health Organisations (ACCHOs) and an overstretched Aboriginal workforce
• limited equitable access to mainstream services due to cultural safety being an issue
• health data and evidence contributing to a focus on deficit narratives rather than Aboriginal holistic understandings of health
• current investment/funding models prioritising tertiary/acute services over early intervention and prevention models
• the difficulty of capturing/monitoring the longer-term outcomes of delivering prevention activities.

Data note

The following measures rely on datasets that are infrequently collected. No new data was available at the time of reporting.

• Measure 11.1.1 Life expectancy at birth, by sex
• Measure 11.1.2 Proportion reporting ‘excellent or very good’ health status, by sex
• Measure 11.1.3 Rate of daily smoking, by sex.

Goal 11 directly aligns with the following Closing the Gap Outcome and Target

Outcome 1 People enjoy long and healthy lives

• Target 1 Close the gap in life expectancy within a generation, by 2031.

Closing the Gap – How Victoria is tracking nationally

Nationally, Aboriginal and Torres Strait Islander males born in 2015–2017 are expected to live to 71.6 years and females to 75.6 years, and non-Indigenous males and females to 80.2 years and 83.4 years respectively.

Nationally, based on progress from the baseline, the target shows improvement but is not on track to be met for males or females.

Aboriginal and Torres Strait Islander estimates of life expectancy are currently not produced for Victoria due to the small number of Aboriginal and Torres Strait Islander deaths reported.

11.1 Improve Aboriginal health status, quality of life and life expectancy

Measure 11.1.4 Rate of hospitalisations for potentially preventable causes (vaccine preventable, acute, chronic and all)

The rate of hospitalisations for potentially preventable causes has increased across both Aboriginal and non-Aboriginal Victorians, but far more markedly for Aboriginal Victorians. In 2018-19, 6.1 Aboriginal Victorians per 1,000 were hospitalised due to vaccine preventable conditions, 21.1 per 1,000 for acute conditions and 35 per 1,000 for chronic conditions. By contrast, rates for non-Aboriginal Victorians were 2.3 per 1,000, 11.6 per 1,000 and 13.2 per 1,000 respectively.

Measure 11.1.5 Incidence of selected cancers

Aboriginal Victorians are 71% more likely to be diagnosed with cancer than their non-Aboriginal peers. In the period 2015–19, on average 251 cancers were diagnosed in Aboriginal Victorians each year, 126 in males and 125 in females. There were 581 new cases of cancer among Aboriginal males and 507 among Aboriginal females per 100,000 people. By comparison, non-Aboriginal Victorian males experienced 349 new cases and women experienced 286 new cases per 100,000 people.

Measure 11.1.6 Rate of emergency department presentations for alcohol or drug-related harm

The rate of Aboriginal Victorians presenting at emergency departments for alcohol or drug related harm have more than doubled since 2008-09, reaching 26.4 per 1,000. Contrastingly, the rate of non-Aboriginal Victorians presenting at emergency departments for the same causes has only slightly increased to 4.5 per 1,000. There has been an even more substantial jump in the presentation of Aboriginal young people (aged 15-24) at emergency departments, with 26.3 presentations per 1,000 in 2019-20 (up from 11 per 1,000 in 2008-09).

Measure 11.1.7 Specialist alcohol and other drug treatment services provided to Aboriginal Victorians

Closed episodes for specialised alcohol and other drug treatments services provided to Aboriginal Victorians have increased substantially. This may be due to increased rates of emergency department presentations leading to increased use of specialist services. Increases in closed episodes pleasingly suggest that once treatment is sought, it is often effective at reducing the need for future treatment.

Key Victorian Government initiatives

Victorian Cancer Screening Framework: Under the Victorian Cancer Screening Framework, VACCHO receives ongoing funding to lead all Aboriginal cancer screening initiatives including partnering with mainstream health services to embed cultural safety practices. The partnership with BreastScreen Victoria through the Beautiful Shawls initiative is an example of an Aboriginal community-led approach which has led to more Aboriginal women screening, including lapsed screeners. This model will be scaled up and applied across the cervical and bowel screening programs.

Victorian Aboriginal Cancer Journey Strategy: The Victorian Government has invested in more than $1 million to provide extra staff, support and resources to VACCHO to develop the Victorian Aboriginal Cancer Journey Strategy. The long-term planning will advance self-determination by developing local approaches which combine culturally appropriate ways to improve cancer outcomes with the best available evidence. The Victorian Aboriginal Cancer Journey Strategy will incorporate a 5-year Implementation Plan, and a Monitoring, Evaluation and Learning Framework.

Goal 12: Aboriginal Victorians access the services they need

Overview

Measures under Goal 12 have continued to improve.

There have been significant increases in the number of Aboriginal people accessing health services across all ages. This includes both younger and older Aboriginal Victorians accessing health checks or assessments and cancer screening services. A greater proportion of Aboriginal Victorians are accessing aged care services than before, despite an increase in the number of Aboriginal Victorians aged over 55. This signals strong progress towards improving outcomes in this goal.

Data note

All measures under the goal are featured

Goal 12 directly aligns with the following Closing the Gap Outcome and Target

The National Agreement does not contain outcomes and targets that align with this VAAF goal. Victoria is pursuing more ambitious and comprehensive goals under the VAAF, which are reported on in this chapter and the Data Dashboard.

Closing the Gap – How Victoria is tracking nationally

Not applicable.

Community, Unity, Immunity Campaign

A community-led initiative was developed in partnership between VACCHO and the Department of Health to encourage vaccinations and provide information on keeping community safe.

Victoria undertook a range of targeted strategies to support the vaccine rollout amongst Aboriginal communities. This included diverting doses from the state supply to ACCHOs, delivering community-based information sessions, creating a youth-specific communications campaign, and establishment of a dedicated Aboriginal COVID-19 Infoline to facilitate uptake.

In addition, to remove barriers to getting vaccinated, VACCHO and ACCHOs offered vaccinations through mobile vaccination vans and culturally sensitive popups across key metropolitan and regional areas with large Aboriginal communities which had lower uptake due to vaccine access and engagement issues.

VACCHO Vaccination Vans

Victoria reached an 80% vaccination mark in October 2021 which led to most public health orders being eased.

VACCHO played an important role in increasing access to vaccinations for member organisations and Aboriginal communities. VACCHO delivered an immediate response through the Victorian Aboriginal Mobile Vaccination Program. The Vaccination Program supported regional communities and member organisations who had limited capacity to provide vaccination programs and identified communities where there was no local Aboriginal community-controlled organisation that provided clinical health services.

VACCHO delivered the Mobile Vaccination Program to help elevate the demand on ACCOs’ workforce, provide COVID-19 clinical services, and support community to access the vaccine. In 8 weeks, this Vaccination Program delivered over 700 vaccines to Aboriginal communities, statewide.

12.1 Improve access to health and community services for all Aboriginal Victorians

Measure 12.1.1 Proportion who received a health check or assessment by age

More Aboriginal Victorians of all ages received health checks or assessments in 2019–20 than in 2008–09. Over 3 times as many Aboriginal Victorians aged 15-54 years received health checks or assessments in 2019–20 than in 2008–09, with almost 6 times the number of adults over 55, and over 6 times the number of children 0–14 years receiving checks or assessments.

Measure 12.1.2 Participation rates for cancer screening

Over twice as many Aboriginal women over 40 years of age accessed breast cancer screening in 2019-20 compared to 2008–09. Although screening rates remain lower than for non-Aboriginal women, this is still a significant improvement.

Measure 12.1.3 Proportion and number accessing the National Disability Insurance Scheme (NDIS)

As of March 2022, 4,509 Victorians identifying as Aboriginal had transitioned to the NDIS with an approved plan. A further 289 Victorians identifying as Aboriginal were in pathway to transition to the NDIS.⁸

DFFH is working collaboratively with the National Disability Insurance Agency (NDIA) to enhance their Aboriginal outreach and community engagement work. The department is also working with ACCOs and Aboriginal communities to support people’s transition to the NDIS.

Measure 12.1.4 Number and proportion accessing aged care services

More Aboriginal Victorians aged over 50 accessed aged care services than in 2019–20 (788 people) than in the past decade (only 244 in 2007–08). However, this represented a lower proportion of all Aboriginal Victorians over 50 than the previous year (6.97% in 2019–20 compared to 7.1% in 2018–19), likely due to people living longer. For the second year in a row, the proportion of Aboriginal Victorians accessing aged care services was higher than that of their non-Aboriginal peers.

Measure 12.1.5 Number and proportion of people aged 55 years or over who had an annual health assessment

The number of Aboriginal people aged over 55 having an annual health assessment increased almost six-fold in the past decade, reaching 1,588 in 2019–20. Consequently, the proportion of Aboriginal people aged over 55 who received health assessments reached 20.8%. This is a slight decrease on 2018–19 (21.1%), despite a higher raw number of assessments. This is due to higher levels of engagement with Aboriginal communities regarding health checks and increased assessments by ACCHOs.

Measure 12.1.6 Services implement strategies, partnerships and campaigns, and offer care and support that is inclusive and address the needs of Aboriginal people who are LGBTIQ+

Pride in our future: Victoria’s LGBTIQ+ strategy 2022–32 is Victoria’s first whole-of-government LGBTIQ+ strategy. It provides the vision and plan to drive equality and inclusion for Victoria’s diverse LGBTIQ+ communities within all aspects of government work over the next ten years.

The strategy recognises that a focus on Aboriginal self-determination will need to be standard to create LGBTIQ+ friendly services. For example, LGBTIQ+ services should be culturally suitable for Aboriginal communities. Likewise, Aboriginal services should be LGBTIQ+ inclusive.

Koorie Pride Victoria

Historically, LGBTIQ+ Aboriginal Victorians have seen a lack of diversity in LGBTIQ+ leadership. They describe the disruption of Aboriginal knowledge of sexuality and gender as a result of colonisation. This disruption has – at times – perpetuated the violence, racism, classism and discrimination against LGBTIQ+ Aboriginal people in social settings and places. This means the full cultural spectrum of their identities is excluded.

Koorie Pride Victoria was established with Victorian Government funding in 2019 to build the visibility, strength and connection for ‘Rainbow Mob’ – Aboriginal LGBTIQ+ people across Victoria. It works to ensure the protection and continuation of Aboriginal cultural heritage through storytelling with Koorie communities, as well as LGBTIQ+ Aboriginal communities.

Koorie Pride Victoria also upholds Aboriginal Victorians’ right to self-determination and celebrates their values and diversity by advocating and supporting culturally safe inclusive practices for Aboriginal peoples identifying lesbian, gay, bisexual, trans and gender diverse, intersex, queer, questioning, Sistergirl and Brotherboy living in Victoria.

Goal 13: Health and community services are culturally safe and responsive

Overview

Measures under Goal 13 have worsened

In Australia, there has been increasing recognition that improving cultural safety for Aboriginal health care users can improve their access to health care and the quality of the health care they receive (Source: AHMAC (Australian Health Ministers’ Advisory Council) 2016. Cultural Respect Framework 2016–26 for Aboriginal and Torres Strait Islander health: a national approach to building a culturally respectful health system. Canberra: AHMAC).

This in turn is likely to improve health outcomes and help to address gaps in health and wellbeing between Aboriginal and non-Aboriginal people.

Culturally safe and responsive health services ensure Aboriginal Victorians feel supported and safe when seeking healthcare.

The increase in Aboriginal Victorians being discharged from hospital against medical advice or at their own risk highlights the need for culturally safe and responsive mainstream services. ACCOs and ACCHOs provide many such services, but further work must be done to ensure mainstream services build cultural safety into service delivery.

Data note

The following measures rely on datasets that are infrequently collected. No new data was available at the time of reporting.

• Measure 13.1.1 Proportion reporting experiences of racism in the health system
• Measure 13.1.2 Proportion reporting positive client experience of GP services
• Measure 13.1.4 Number and proportion of Aboriginal people employed in the health or social services sector

Data for Measure 13.1.4 relies on Census data.

Data for these measures is available on the Data Dashboard, which can be accessed via the First Peoples – State Relations website.

Closing the Gap – Relevant Outcomes and Targets for Goal 13

The National Agreement does not contain outcomes and targets that align with this VAAF goal. Victoria is pursuing more ambitious and comprehensive goals under the VAAF, which are reported on in this chapter and the Data Dashboard.

Closing the Gap – How Victoria is tracking nationally

Not applicable.

13.1 Increase the cultural safety and responsiveness of services

Measure 13.1.3 Hospitalisations where patients left against medical advice/ were discharged at own risk

747 Aboriginal patients left hospital against medical advice or were discharged at their own risk in 2019–20 – 11.7 people per 1,000. This is a considerable increase from 324 Aboriginal Victorians in 2011–12 (6 per 1,000) and remains substantially higher than non-Aboriginal Victorians (15,581 non-Aboriginal Victorians or 2.3 per 1,000 in 2019–20).

There may be many reasons for Aboriginal patients leaving hospital against medical advice. Aboriginal adults in Victoria are 47% more likely to experience racism in a healthcare setting than non-Aboriginal Victorians.⁹

The impact of intergenerational trauma, distrust, Western models of care and remoteness are additional factors. Family and community obligations may be an additional reason.

Strengthening Aboriginal cultural safety in mainstream health services

Aboriginal people are 47% more likely to experience racism in a healthcare setting in Victoria than non-Aboriginal adults. This is a key barrier to closing the gap in Aboriginal health and wellbeing outcomes.

The Department of Health (DH) is committed to strengthening Aboriginal cultural safety in Victoria’s mainstream health services as it is critical to improving health equity. Leadership across the health system is required to make the change.

Progress in 2021–22 has included improving mainstream health service accountability for Aboriginal cultural safety through the Statement of Priorities for hospitals. DH has also funded VACCHO for a ‘cultural safety tick’ accreditation feasibility study, and cultural safety tools and resources. Next steps will focus on increasing accountability through improved data collection and cultural safety measures in health services’ Performance and Monitoring Framework. Consideration will also be given to expanding accountability across the whole system, including Health Service Partnerships, Local Public Health Units and other health services.

Goal 14: Aboriginal Victorians enjoy social and emotional wellbeing

Overview

Measures under Goal 14 have worsened

Aboriginal concepts of social and emotional wellbeing recognise that many factors contribute to holistic wellbeing, including connection to Country, culture, family and community. Mental health is a key component, as well as social, emotional, spiritual and cultural wellbeing.

Racism is another key determinant of health for Aboriginal people. The physical and mental health of Aboriginal people is adversely impacted by ongoing racism. There is an abundance of high-quality scientific studies that show that racism is not just harmful to mental health, it is also harmful to physical health. (Source: Department of Health and Human Services, Racism in Victoria and what it means for the health of Victorians, 2017, 16–17, https://www.health.vic.gov.au/sites/default/files/migrated/files/collec…).

Concerningly, while many Aboriginal Victorians enjoy excellent social and emotional wellbeing, and mental health, levels of psychological distress and rates of self-harm have risen substantially in the past decade, especially for Aboriginal young people. These issues are reflected in the findings of the Coroner's Court of Victoria report – Suicides of Aboriginal and Torres Strait Islander people, Victoria 2018-2021. Government must do more to address this.

Data note

The following measures rely on datasets that are infrequently reported on. No new data was available at the time of reporting.

• Measure 14.1.1 Proportion reporting ‘high or very high’ levels of psychological and psychosocial distress
• Measure 14.1.3 Proportion reporting strong social networks they can draw on in times of crisis
• Measure 14.1.4 Proportion of Aboriginal Victorians with a disability that have strong social support networks.

Goal 14 directly aligns with the following Closing the Gap Outcomes and Targets

Outcome 14 Aboriginal and Torres Strait Islander people enjoy high levels of social and emotional wellbeing

• Target 14 Significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.

Closing the Gap – How Victoria is tracking nationally

Nationally, based on progress from the baseline, progress towards the target is worsening.

Current reporting is only for jurisdictions which have adequate levels of Indigenous identification in line with national reporting guidelines (NSW, QLD, WA, SA and NT). Future reporting aims to include additional disaggregation for all states/territories.

14.1 Improve Aboriginal mental health and social and emotional wellbeing

Measure 14.1.2 Rate of self-harm related emergency department presentations (by 15–24 years, and all)

37.5 of every 1,000 Aboriginal Victorians that presented to emergency departments in 2019–20 did so in relation to self-harm. This is a concerning increase from 5.6 per 1,000 in 2008–09, and is a considerably higher rate than for non-Aboriginal Victorians. These rates reflect the significantly poorer mental health, wellbeing and safety outcomes experienced by Aboriginal people. The legacy of intergenerational trauma and experiences of systemic racism and discrimination are key drivers of these outcomes, which must be addressed holistically through integrated, culturally safe and responsive services.

Measure 14.1.5 Number of Aboriginal Victorians receiving clinical mental health services

Aboriginal people were 3.9 times more likely to access community mental health care services than their non-Aboriginal peers in 2019–20. 1190.7 Aboriginal people per 1,000 accessed these services in 2019–20, compared to 302.0 non-Aboriginal Victorians per 1,000.¹⁰

Embedding healing practices in social and emotional wellbeing services

The Royal Commission into Victoria’s Mental Health and Wellbeing System (the Royal Commission) held in 2019 recognised the urgent need to address mental health issues in Aboriginal communities and the central role of self-determined Aboriginal social and emotional wellbeing services in improving Aboriginal social and emotional wellbeing outcomes.

Aboriginal organisations and witnesses called on the Royal Commission to promote and embed healing practices in social and emotional wellbeing services in Aboriginal communities. In response to the Royal Commission’s recommendations, the Victorian Aboriginal Community Controlled Health Organisation launched the Balit Durn Durn Centre of Excellence in Aboriginal Social and Emotional Wellbeing (Balit Durn Durn Centre) in May 2022. The Balit Durn Durn Centre coordinates best practice in Aboriginal social and emotional wellbeing that draws on healing and the protective role of culture, identity and connection to Country for Aboriginal social and emotional wellbeing.

The Balit Durn Durn Centre has also commenced a co-design process with Aboriginal communities and organisations to develop an Aboriginal-led service model to inform the establishment of two Aboriginal healing centres by 2026, a key recommendation of the Royal Commission. The focus on healing marks a further shift away from the crisis‑driven care that characterises much of the state’s current response to mental illness.

Working in partnership with VACCHO to support Aboriginal Social and Emotional Wellbeing

The Mental Health and Wellbeing Division (MHWD) within the Victorian Department of Health has established a very strong and collaborative partnership with VACCHO to jointly deliver key recommendations from the Royal Commission into Victoria’s Mental Health System.

The partnership involves shared decision-making and bi-monthly meetings. A working group between VACCHO and MHWD meets weekly to progress the work and decisions of the partnership. This is a collaborative and unique way of working that leads to better progress and keeps partners informed at every step of the way.

Key work that has been achieved through the partnership is the development and delivery of a scholarship program to assist Aboriginal people to complete further education in clinical and therapeutic mental health qualifications. In the first round of scholarships, 13 scholarships were awarded across social work (with a specialisation in mental health), mental health nursing and other related degrees. This will build an increased Aboriginal social and emotional wellbeing workforce.

Domain 4: Victorian Government Investment and Action

The Victorian Government is working with service providers, Aboriginal organisations and communities to ensure that all Aboriginal Victorians have access to high-quality, culturally safe and responsive health and wellbeing services.

The key Aboriginal Governance Forums for realising outcomes in this Domain are the Aboriginal Strategic Governance Forum and the Victorian Aboriginal Health and Wellbeing Partnership Forum.

Disability

Key investment in 2020–2021

• Targeted engagement for Inclusive Victoria delivered by partner First Peoples Disability Network (FPDN) Australia ($15,000).
• Self Help Grants Program 2019–2021 – Aboriginal focused grants ($15,000).
• COVID-19 pandemic Outreach Funding ($150,000).
• Funding to improve the cultural safety of the Forensic Disability Program ($150,000 annual recurrent funding)
• Funding of $300,000 was allocated to VACCHO in 2021–22 to help develop a workforce that more fully reflects the diversity of Victoria’s NDIS participants. Strong ACCOs Our Way will support organisations to adapt their processes to meet the operational requirements of NDIS service delivery and provide more choice to Aboriginal NDIS participants.

COVID-19 pandemic Aboriginal disability outreach program

In May 2022, three regional cooperatives received funding through the Victorian Disability Advocacy Program to provide practical outreach in response to the COVID-19 pandemic, by building on their local partnerships to support people with disability from Aboriginal communities and their families.

In one case, a woman with disability was referred to an advocacy organisation by her local Cooperative for assistance in claiming the Disability Support Pension (DSP). The advocacy organisation connected her with its Aboriginal advocate.

The advocate’s support allowed the woman to secure the DSP, access more appropriate, specialised care from a clinical psychologist and to address various issues with Centrelink.

The woman is now confident to contact her advocate for support and is looking at accessing the National Disability Insurance Scheme, which will slowly allow her to access her community more.

Aboriginal Liaison Officer position within the Forensic Disability Program

Aboriginal people are over-represented amongst forensic disability clients, with about 25 percent of all clients identifying as Aboriginal or Torres Strait Islander.

The Forensic Disability Program provides treatment and support for people with cognitive disability who are involved in the criminal justice system, reducing their likelihood of reoffending and helping them improve their lives.

The program’s new Aboriginal Liaison Officer has worked to amplify residents’ voices and improve cultural safety within forensic residential services. This was achieved by a range of activities, including engaging with Elders, developing a Gathering space/yarning circle, building a healing garden and acquiring Aboriginal artwork for shared spaces.

Inclusive Victoria: State Disability Plan 2022–2026 (Inclusive Victoria)

In 2021, the Office for Disability engaged First Peoples Disability Network (FPDN) Australia, a national peak run by and for Aboriginal people with disability, to undertake targeted engagement to help shape the next state disability plan.

FPDN hosted two workshops and 11 interviews in Ballarat and Horsham with 64 people from Aboriginal communities with lived experience of disability either as a person with disability or as a family member of a person with disability. This feedback, along with other targeted engagement, informed development of the commitments and actions in Inclusive Victoria.

As well as Aboriginal portfolio-specific actions across housing, justice and children and families, Inclusive Victoria includes a focus on Aboriginal self-determination as one of six systemic reforms to drive whole-of-government long-term change for people with disability.

This reform area commits government to working in partnership with Aboriginal communities to drive action and improve outcomes for Aboriginal people with disability underpinned by principles of Aboriginal-led collective action, Aboriginal self-determination and systemic change. This includes:

• continuing the government’s commitment to work closely and in good faith with Aboriginal stakeholders to ensure Aboriginal people with disability have power, control and decision-making and are able to co-design policies, programs and services that affect them
• Aboriginal representation on the Victorian Disability Advisory Council and related government working groups, as well as engagement with any self-determined representative body for Traditional Owners and Aboriginal Victorians established through treaty
• further developing the capacity for the Aboriginal community-controlled sector to deliver disability support services
• strengthening the Aboriginal disability workforce.

Inclusive Victoria also commits to working to address Indigenous data sovereignty and incorporation of Aboriginal-defined evidence and measures of success.

Health and wellbeing

Strategies to support improved eye health within Aboriginal community

This includes but is not limited to recurrent funding for supporting the Aboriginal Spectacle Subsidy Scheme through the Australian College of Optometry and, through the Victorian Eyecare Scheme and participation in the Victorian Eye Health Strategy Committee

Strategies to support cancer care

Strategies have been established, including:

• implementation of the Victorian Cancer Agency Collaboration Research Grant
• implementation of the Optimal Care Pathway
• investment in VACCHO to support development of strategic direction, capacity building, early decision and screening, and development of data and evidence to ensure cancer care and journey for Aboriginal community is culturally safe
• continued focus on reducing high rates of smoking through delivery of culturally safe and accessible information and promotional programs, investment in VACCHO to support capacity building, training and resources for the community-controlled sector, and delivery of place-based events and programs.

Keeping Aboriginal Victorians during COVID-19 safe, supported and connected program

The Program assists ACCOs to support COVID-19 positive patients and to strengthen primary health care to address to reduce the need for hospital admissions and emergency department presentations through a flexible, needs-based funding approach.

Efforts were focused on increasing vaccination rates with the community-led response including mobile vaccination vans, bespoke culturally sensitive vaccination pop-up clinics and spaces in vaccination sites, surge workforce support and the establishment of a dedicated Aboriginal COVID-19 information line.

Place-based responses through partnerships with Local Public Heath Units were also a focus, including communication and engagement activities, supporting COVID-19 positive community members and supporting vaccination and testing activities.

Aboriginal Workforce Fund

The $40 million Aboriginal Workforce Fund (AWF) is designed to boost the Aboriginal community, health and family violence workforce as communities recover from the pandemic. The design of the fund aligns with the Korin Korin Balit-Djak system transformation strategy and focuses on embodying Aboriginal world views, respecting Aboriginal systems and ways of working, and delivering greater agency and control.

Government’s commitment to the AWF was focused on providing funds to Aboriginal organisations to support their needs and priorities based on consultation with the sector, rather than prescribing focus areas. This created an opportunity for priority setting and decision

An AWF Steering Committee made up of Aboriginal community stakeholders was established to guide direction and decision-making of the fund. Committee members brought a range of interests and perspectives to the table. As well as advancing self-determination, the Steering Committee is guided by the principles of promoting cultural safety, minimising reporting burden and supporting Aboriginal-specific measures of success.

From the beginning of the AWF process, sector representatives called for an inclusive, straightforward, non-competitive process that would help maximise access for smaller organisations, and focus on self-determined outcomes. The AWF demonstrates a good step towards a more self-determined approach to supporting the sector – in this case, its workforce development needs. Lessons and reflections from the AWF can be built on to progress funding reform, drive the sustainability of Aboriginal organisations, and continue to transfer more power and control to communities.

Mental health and wellbeing

Continued funding of the Yarning SafeNStrong 24-hour Aboriginal helpline

The helpline provides counselling support to callers experiencing anxiety, distress and mental health challenges. It provides outbound referrals to local ACCOs who provide social and emotional wellbeing and mental health services as well as referrals to other support services (state-wide and local services).

Growth in Aboriginal social and emotional wellbeing

The Aboriginal mental health workforce was also supported by the establishment of 8 Aboriginal Mental Health Traineeships within the Adult Area Mental Health Services, and the significant expansion of the Aboriginal Social and Emotional Wellbeing (SEWB) workforce in Victoria with recurrent funding to progressively establish 25 multi-disciplinary SEWB teams in ACCOs over the next five years. The multi-disciplinary SEWB teams are providing social and emotional wellbeing supports and services that are holistic, culturally safe and healing focused. This includes continued funding for 10 clinical and therapeutic positions.

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⁷ VGAAR 2020 p65.

⁸ Please note these are cumulative figures from the start of transition.

⁹ The health and wellbeing of Aboriginal Victorians. The Department of Health, 2021 (Findings from the Victorian Population Health Survey 2017) p 37.

¹⁰ Contacts over 1,000 per 1,000 reflect that patients may have multiple contacts in each reporting period, and that contacts may be with both the patient themselves, or with a third party such as a carer, family member or mental health worker.