Transcript for
Effective engagement of Aboriginal and Torres Strait Islander families in mainstream services

Runtime 00:24:51
Released 29/5/19

Narrator [00:00:02] Welcome to the Emerging Minds podcast.

Sophie Guy [00:00:07] You’re with Sophie Guy, and today I’m speaking with Bill Wilson about effective engagement of Aboriginal families and children about their child’s social and emotional wellbeing. Bill Wilson is a narratively trained social and emotional wellbeing worker who has worked extensively in the fields of alcohol and drugs, child protection, child and adolescent mental health services, aboriginal education and Aboriginal men’s health. He has a strong belief in the power of Aboriginal people and communities to be the change agents in their own lives.

[00:00:37] Well, thank you very much, Bill, for coming in today and having a chat to me, I really appreciate it.

Bill Wilson [00:00:41] No worries, Sophie.

Sophie Guy [00:00:42] Could you start by telling us a bit about your background and how, how you came to work in Aboriginal social and emotional wellbeing?

Bill Wilson [00:00:49] My background is quite varied. You know, I’ve worked in public service. I worked in there for 14 years. So in, primarily in those roles, there was work in Aboriginal health, specifically, working within that within Aboriginal men’s health. I also worked in the area of child protection in Families SA, worked in Aboriginal education within that and also started a program in Murray Bridge working for Child and Adolescent Mental Health Service, CAMHS, working with young people, Aboriginal young people around their mental health. And more recently, I’m doing some work with the Ngarrindjeri Regional Authority where I’m the acting CEO. And we’ve recently become an Empowered Communities, which is a federally government funded framework that looks at putting some more power and ownership of how Commonwealth dollars are spent within the Murraylands region.

Sophie Guy [00:01:50] Okay. What’s important to know about child social and emotional wellbeing from an Aboriginal perspective? Or maybe it’s from your perspective, I’ll let you tell me.

Bill Wilson [00:01:59] You know, I think for me it’s very much in that holistic sense. I think some services may not focus on one particular area of a young person. I think we can’t do that in isolation, I think we have to take into account all the issues that surround that particular young person from, I guess, some of the challenges that they face as a young person to the dynamics of the family. Not always assuming that it’s, it’s mum and dad, it’s in particular in Aboriginal families, the extended family, particular grandmothers, the roles that they play. What else is going on for that young person in the context of his own community, and then then also, who are the other service providers that may be providing support into that young person or that family? And how can we work more collaboratively in that wraparound services to our Aboriginal young people or our families?

Sophie Guy [00:02:57] So what does that look like to engage or perhaps work as a practitioner holistically with, if you’re faced with an Aboriginal young person, a child, what would it look like to work holistically with them?

Bill Wilson [00:03:10] That would be certainly about building relationships with all the key people in that family, not not just the child in isolation. And that takes time around building a sustainable relationship. And I think sometimes the service providers, we just need to just kind of slow that down and be conscious that that first engagement is a really important one to building a foundation. And I think it’s about getting that trust, you know, in terms of them trusting you as the practitioner, as the organisation. And then and then you build that steadily over a point of time. But you know, I’m all about the relationship. And I think Aboriginal people are relational people.

Sophie Guy [00:03:59] And what does. Could you just talk a bit more about building a relationship? How do you if if you’re met with an Aboriginal family, how do you build a trusting relationship with them in a, in the first go?

Bill Wilson [00:04:10] As an Aboriginal practitioner, one of the things I give of myself in that initial engagement and I certainly won’t be taking notes or doing any assessments on the first engagement. And within that in that initial engagement, it’s about identifying who your mob is if you’re an Aboriginal practitioner. And that’s what I meant by giving something of yourself to that, and it’s around trying to create a connection within that. So in that first engagement, I’m probably speaking more than than they are and offering up something of myself in terms of building that relationship. Who I am, who my mob is and whether there’s some connection made through their family to mine. So, you know, for a non-Aboriginal person, obviously, it’s a different task. In terms of creating that, but I still think by not trying to go to the issue at hand on the first engagement, I would steer away from that. I’d be really about trying to build that rapport in that first initial engagement. And I think it’s about trying to get them back in the door the second time. Many organisations can get people through the door once. There’s a great saying I always like to use is that you know, people will vote with their feet. If they derive something from that initial first engagement, and you can get them to vote with their feet in coming back in a second time, a third time, then you must be doing something that’s engaging for them to keep coming back.

Sophie Guy [00:05:52] Uh-Huh [yeah]. Could you tell me a bit about services and programs that do get this right where Aboriginal people do come back and repeatedly use the service? And, what are they getting right in that?

Bill Wilson [00:06:06] I guess the one I’ll speak to is the one when I was employed with the Uniting Communities. And we’re working with Aboriginal people around issues of alcohol and drugs. You know, I think early in that model, it’s around how do you get the the clinical models to marry up with the Aboriginal cultural context? And I think early in that program, we we didn’t have the match right. It was very strong in the clinical sense and not a lot of cultural context in that. So it’s around trying to get the balance where they can exist together. And given that we were working in an Aboriginal-specific program at the time and part of my role was to ensure that there was a cultural context in there. So we develop some tools that assisted the people that worked as practitioners in our in our program, cultural, cultural tools. When we knew we started to get that program moving in a stronger direction where more Aboriginal people became involved in the program was when we started to receive some peer referrals. So it wasn’t, it wasn’t government agencies referring into that, it was people that were actually using the program that were talking to their family and then were talking to their friends and saying, hey, look, this program helped me.

Sophie Guy [00:07:30] Okay. I’ll switch back now to getting into the practice again and what is important for non-Aboriginal practitioners and practitioners to know about engaging Aboriginal community, parents and children?

Bill Wilson [00:07:44] I guess when I was working with a lot of… well when I was the only Aboriginal worker within CAMHS, I got that question asked of me a lot. And I guess one of things I said is like, don’t overcomplicate it. If we could just pare it back that that first engagement, either with that young person and with that family is very important. You know, one of the policies that I changed when I was working within CAMHS was once a referral come in, they allocated five appointments for you to see that person and then transition them out. And I said, look, if we’re gonna build a better reputation with the Aboriginal community, with CAMHS, we have to do away with that, that internal policy because it might take me three times to build some sort of trust with that particular young person. And I always included their family as a part of it. I couldn’t justify a transition out of that program in five engagements. So I’m proud to say that we done away with that policy. CAMHS at that point had a number of Aboriginal young people that were being referred in, but 80 per cent of them will be seen once and never seen again. [Okay]. So the program that I came into was to look at addressing that particular need. So there were some recommendations that I’ve put in place that one was doing away with the five, five appointments only and then also developing some cultural context conversations that could be included within, within their assessment tools. And that was a little challenging because I worked with everyone from a mental health nurse background, social work background, OT background, psychologist background, psychiatrist, and there’s a range of people that work within there and they all had their own models of engagements that they worked from. And so it was around supporting them all in that, but also looking at their own caseload and how many Aboriginal people that they would see, and only once. And over a period of a couple of years, we started to get some more traction in Aboriginal young people and families coming back voting with their feet.

Sophie Guy [00:10:16] What are the main challenges or barriers to effective engagement of Aboriginal families in non-Aboriginal services?

Bill Wilson [00:10:24] There’s a whole history there of what various child protection acts have, have done to our Aboriginal families, and I’d still say that that fear is very real for our Aboriginal families in terms of what I share with you as a clinician, as a practitioner. You know, it still happens that we still have shocking rates of Aboriginal children being removed today. They’re (at) an all-time high. Effectively, we’re creating another stolen generation of Aboriginal children into a system which I don’t, which I actually personally believe should be part of our close-the-gap KPI. So I really feel that [it’s not] it’s not [right]. Currently, it’s not. It’s almost an unspoken, not very well publicised around the rates of Aboriginal children coming into the child protection system at the moment.

[00:11:26] So we get a lot of our families not feeling that they can speak openly about whatever issues are impacting their family. You know, whether that whether that information, whether their story is going to be respected by that clinician, respected by that organisation in terms of what people are prepared to to share. You know, I think it’s about how, how Aboriginal people become engaged with that organisation. Is it mandatory for them to turn up to an organisation because it’s of the directive of Department of Corrections, say, by all the courts or the Department of Child Protection. All these things contribute to you know, Aboriginal people walking into an organisation for the first time. I think as service providers, we have to have some understanding of that and some respect in that that they’ve initially, they have opened the door, they have came in, even if it is in a mandated sense as a service provider, you should look at that as a, as an opportunity to impact on that family.

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Narrator [00:12:42] You’re listening to an Emerging Minds podcast.

Sophie Guy [00:12:48] Is it helpful for practitioners to non-Aboriginal practitioners to have a conversation around fear, around child protection or to touch on the intergenerational trauma? Is that a useful part of any conversations?

Bill Wilson [00:13:04] I think it’s about maybe putting some questions to them about why they’re here and asking the question of them, what are your concerns [Yep, uh-huh] from within that? So if, if within that they identify some of those issues, then I think that’s a space to unpack that a little bit and have that conversation with them. Most service providers are mandated notifiers, and it’s a part of your practice to declare that straight up. [Yep]. And you know, in all roles that I’ve been in, I do have to declare that around, in and around that. But I think in that initial engagement, that that’s an opportunity to open that, to open that space up. And if you do get some of those sort of things around those concerns, then to have a conversation, an open conversation about that. When I went for CAMHS, one of the things that were clearly identified was that our Aboriginal community had a perception that CAMHS was attached to child protection. [Okay]. A lot of families didn’t understand the context that well actually, it’s just, it’s a completely separate department still within state government. It has a relationship with the child protection, but our, overwhelmingly our community just thought that we were a part of the child protection system and which probably, which probably identified why a lot of our, a lot of our families were only seen once and never engaged again. So it was almost a, an education process of speaking about CAMHS as a service provider, being very different to what it was known back then, Families SA child protection. Yeah. [Yeah]. So it was almost sort of debunking some of those myths [Yep] that still sit within our, our communities and families around some of that fear and trust, trust issues. But I think in terms of how do we support non-Aboriginal practitioners in that space? You know, I think there’s some stuff that you could do internally around some cultural context training within that that can support whatever models of care and engagement that they utilise. And that was something that we invested in in my time at CAMHS.

Sophie Guy [00:15:28] That kind of links to the next question I wanted to ask you around what is good practice at the service or organisation level to support Aboriginal community in Aboriginal families?

Bill Wilson [00:15:40] I think at CAMHS is that you should be trying to empower them, empower them to be their own change agent in their lives. And I know initially it’s around maybe building up and imparting some skillset to them around some of that management of their own issues. But I think for anything to be sustainable around change (is) that we need that to be led by that individual within that family. And I think as a service provider that that should be an aim that we, that we empower the individual to lead their own lives. I’m narratively trained, I think it’s a good model for for our Aboriginal people. We’re natural storytellers. But how do you build a safe space where you can get someone to share their story? And in many cases, it’s easy to talk about the problem story because you live within that context of the problem story. It’s around how do you build the trust to say, okay, if you were to transition and these issues of alcohol and drugs and relationship issues were not present, what would your preferred story look like? What does that transition to that journey look like? For me, when I would always get someone to speak openly to that, you could almost see like a physical transition where it’s a bit more light in their eyes that the shoulders go back. There’s a passion for people to want to, want to move to a better life, whether that’s for themselves, for their children, for their immediate, extended family.

Sophie Guy [00:17:28] You’ve talked a little bit about narrative therapy. Are there other models that may come from in you know, western clinical models or maybe have been developed in Aboriginal cultural context that are also supportive?

Bill Wilson [00:17:42] Yeah, yeah. For me, I use a bit of motivational interviewing as well. [Yeah]. Remember when I started being exposed to MI (motivational interviewing), I was working for CAMHS at the time, and it was a bit confronting to me because you have to give some air space to what is positive about… maybe if it was their drug use or the alcohol misuse. You had to give them some air space to kind of articulate what were some of the positive things about that and when I gave some air space, some time for them to articulate to me what was positive about that for them. And, you know, some of things I heard about it is that it kept them socially connected. Even though they knew what they were doing wasn’t in their best long term interest, but it kept them connected to a group.

[00:18:36] I remember one lady explained to me, “Bill, I know it’s not in my best interests. I know it’s not in my kid’s best interests. But I’d rather be wrong but still be connected then doing the right thing but being in isolation.” [Yeah]. So for me to hear that, it was an opportunity for me to unpack with them around what this isolation thing was and that there would be other people that would, would support her in that transition. She just had to look outside of her immediate supports to identify that. She came to a realisation herself, which I think was the greatest, was the greatest thing that she didn’t need anyone to point that out to her, that she just needed to look a bit harder. Take herself out of her comfort zone that she’d been living in. For some of our mob, it’s 20, 30 years living a particular life. And I like to think as Aboriginal people we’ve got to get more comfortable in having uncomfortable conversations or changes that we want to bring about in our lives.

Sophie Guy [00:19:50] Uh-huh. [Yeah]. Mhm. [Yep]. Is there anything else that we haven’t covered or haven’t kind of asked that you’d like to share today.

Bill Wilson [00:20:00] Yeah there’s probably a couple of things. Some of the work that I’ve done more recently in Victoria is that I’ve been involved in a program that’s worked with Aboriginal men who are, who are incarcerated. So in Victorian prisons and you know, one of the things I’m really conscious of with our mob is, is that when people are disconnected from their culture, from their identity and from their mob, there’s a whole range of issues that can can impact on Aboriginal people.

[00:20:35] And I think one of the by products or what it manifests itself into is issues of self-medication, in terms of alcohol, drugs. And I think that’s something that service providers we should always be… have in the back, in the back of our minds is that we should never really underestimate what their own cultural identity is as well.

Sophie Guy [00:21:03] The importance of that.

Bill Wilson [00:21:04] Absolutely, yeah. The absolute importance of that and feeling as Aboriginal people, as I said, I think we’re relational and we’re also very spiritual beings. And when we don’t have a cultural identity that I’ll describe that that spirit is is interrupted. And if we can be conscious of that and and work with the individuals. Some, it’s a very, very uncomfortable conversation to have with it, with our people around their own cultural identity. But once again, if we can get more comfortable in having that uncomfortable conversation, sometimes that’s really pushed down and really suppressed and as I said it manifests in in other ways if that, if that issue is not addressed or not not spoken to.

Sophie Guy [00:22:03] I imagine there’s a lot of hard emotions attached to that, a lot of grief and rage, perhaps anger. Yeah, yeah.

Sophie Guy [00:22:10] Yeah a wide variety of issues that are that are connected to that. And I think a lot of our Aboriginal organisations work in a model where that’s at the forefront of their minds in terms of that engagement. But it’s really about where people are on their you know, whether they’re prepared to have that conversation, whether they’re prepared to look into that. A lot of the men that I came across in in those Victorian prisons were searching, searching for their mob, searching for a connection, desperate for some type of connection. [Yeah] That that can actually ground you in that cultural identity and you can actually complete that, complete that spirit.

Sophie Guy [00:23:00] Yeah, I feel that. Yeah, it’s deep isn’t it? [Yes]. Yeah. Is there anything else that you wanted to to continue about that point or…?

Bill Wilson [00:23:11] Nah I think the, I think they’re the key themes I guess I wanted to sort of wanted to convey here today, but yes, sustainable change will come from within. If you want it to be a long term strategy that whilst you might have some motivation to do it, an external motivation I hear a lot about is children and family, and I get that because we are as Aboriginal people, we’re very connected to our families and clearly our children in that. But I guess what I try to impart is that, you know, it’s great to have those external factors, but you need that inner, that inner drive off of self as well. And that you got to want to do it for yourself. If you can focus on yourself, get yourself strong, then you can be all that you want to be to your children, to your family, to your community.

Sophie Guy [00:24:06] Okay. We may finish up there. Thank you very much for your time. It’s been a really great conversation.

Bill Wilson [00:24:13] Thank you, Sophie.

Sophie Guy [00:24:14] Thanks, Bill.

Narrator [00:24:17] Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.

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