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(SPINZ National Symposium 2009 Culture and Suicide Prevention in Aotearoa)
(Dr Tracy Westerman Indigenous best practice)
(Learning the importance of evaluation)
I was actually talking about culture-bound phenomena
and I had a professor of psychology say to me
that there's no evidence that culture-bound... or cultural illness exists.
And I actually said to him, my response to him was, that you're absolutely correct.
And people were quite surprised.
And I said, "You're absolutely correct in the world in which you live."
So you actually can't necessarily blame someone
if they've never actually been exposed to it before.
So, the important point is that, if you actually don't have it in a framework
that most people, and what I'm talking about is mainstream, can relate to,
in that it's actually researched,
and it's written up in a scientific journal,
then they're actually forced to relate to it.
Or at least open their, you know, mindset up to a different reality.
(Limitations in mainstream assessment for indigenous populations)
You'd actually ask people questions like,
"Have you seen spirits?" You know?
"Have you actually seen things that noone else can see or hear?"
And Aboriginal people would say, "Yes!"
And on the test you actually had to mark them down as
having a potential psychosis.
There are other things, too, in terms of our grief processes.
When someone passes away, as part of our grieving we actually cut ourselves,
as an expression of grief, it's quite a common thing.
We call them 'sorry cuts'.
And there was a mental status exam that said, that actually asked the primary question,
"Do you engage in deliberate acts of self harm?"
And you can actually be sent into a psychiatric ward on the basis of answering yes to that question alone.
Most Aboriginal people would answer yes to that,
because it's a normal part of our cultural grief.
So there were so many examples of those sorts of things
that basically people were getting things very wrong, you know?
And not actually understanding the culture at all.
(Bringing cultural and clinical workers together for training)
Language marginalises people.
It marginalises Aboriginal people because we don't have access to the flash clinical words.
So you can be a really good cultural worker, and you can actually know what's going on for your client
but when you go into a clinical world,
because you can't speak that language,
because you can't articulate it in a way that mainstream will pay attention to,
you're quite often dismissed.
The other thing is with, if you're a clinician, or a non-Indigenous person,
and you're go into a cultural world, you're also marginalised, too,
because you don't have access to our words and our language. You know what I mean?
So the focus of a lot of the work that I do
is actually teaching people that dual language.
So if you want to go into...
And that's why when I train Aboriginal and non-Aboriginal people
I actually use language as a primary focus,
so I'll actually explain the clinical term,
and then I'll explain the cultural term at the same time
So that everyone is actually learning,
basically, a common language and meeting together.
(Communities taking action: The Derby example)
Two young girls who, again,
Derby... suicide rate one of the highest in the world,
And we'd been doing the training in Broom, which is about two hours away,
and they happened to come along and, again, said,
"We're seeing all these things in our communities, and with our friends,
"and with our cousins, and, you know, we need you to come and talk about this stuff."
So they kept pushing the Government, and eventually got funding, and again,
we designed three different packages.
Which basically meant that we trained service providers,
we trained community people, which is elders and parents
and a range of people, and youth.
So the packages were actually very different
in that the service providers' was around, how do you work better with Aboriginal people?
How do you do counselling better?
How do you do suicide intervention better?
Community was around, how do you recognise these things?
What can you do when these things hit?
What sorts of coping strategies do you need around effective communication?
All those sorts of things.
And same with the youth. It was basically psycho-educative.
So the packages were unique in that we targeted the whole community.
Now that's the beauty of going out to communities,
is that you can see actual change.
That's the great thing about it,
is that you can have a community, population: 2,000
and the Indigenous population is probably about 30% of that,
and we had most of them there [laughs].
So basically everyone is learning the same things,
speaking the same language,
and they all know what to do.
So initiatives like that are extraordinary,
but we had, like I said, 117 people turn up in six days.
So we did two days of service providers,
two days with community,
two days with youth... Sorry, 7 days:
and then we had one day where we got everyone together
and developed an action plan.
And then we followed them over 18 months.
So it was only three phases,
but we basically followed them over 18 months.
To the point that they were actually running the programmes themselves.
So now we actually deliver those Australia-wide,
which is just absolutely fantastic.
(www.spinz.org.nz)