Creating Futures 2010 Conference

Harnessing creativity and social enterprise for mental
health and wellbeing

Mick Gooda

Aboriginal and Torres Strait Islander Social
Justice Commissioner

Australian Human Rights Commission

Cairns

20 September 2010

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I begin today by thanking Granny Alice Yeatman for her warm welcome to
Yarrabah and paying my respects to the Traditional Owners, on whose land we meet.

Good morning ladies and gentlemen,
my Aboriginal and Torres Strait Islander brothers and sisters, distinguished
guests.

I am of the Gangulu people from the Dawson Valley in Central Queensland and
when I speak to my Elders, they ask me to pass on my salutations to the
traditional owners of the land I visit, and thank them for their continued fight
for their country and their culture. But today I also acknowledge their
graciousness in sharing their lands and their culture with all those who live
and visit here in the spirit of reconciliation.

I would also like to commit
to two things, the first is that I commit to respecting their culture and their
country. Secondly, I commit to leaving both their culture and their country in
the same condition as it was when I arrived here.

Can I also particularly acknowledge my fellow Directors and Dr Jennifer
Bowers, the CEO of the Centre for Rural and Remote Mental Health Queensland. I
continue to be proud to be part of the Centre since its inception and the way it
has developed over those years gives all of us involved in one way or another a
great deal of which to be proud.

When we first started out in this venture, to put some practical meaning to
the vision of people like Ernest Hunter, we had the opportunity to build an
organisation from the ground up to ensure:

‘ Rural and Remote Queenslanders, whoever they are and wherever
they live are able to access the best possible information and services that
support their mental health and wellbeing, helping them to think, learn and live
well with their own emotions and with those of others’.

Conferences such as this one because it shines light on the issue of
Aboriginal and Torres Strait Islander mental ill health; an issue that is often
overlooked in discussions around Indigenous disadvantage and in relation to some
of the headline issues associated, often unfortunately, with Indigenous
Australians in the media.

Yet, without addressing mental ill-health as an issue in its own right,
efforts to improve life in many Indigenous communities, both urban and remote,
are likely to come undone. Poor mental health contributes to the crisis of
family violence, anti-social behaviour, substance misuse, confrontation with the
legal system, low participation in schooling and employment that is evident in a
significant number of Aboriginal and Torres Strait Islander communities.

The statistics speak for themselves. Mental health is BIG issue for us.

In terms of our emotional and social well-being, the 2004-2005 National
Aboriginal Torres Strait Islander Health Survey found that Indigenous people
aged 18 years or older were twice as likely as their non-Indigenous counterparts
to feel high or very high levels of psychological distress.

And this is consistent with our higher experience of significant stressors
including the 'death of a family member or friend', 'alcohol or drug related
problem', 'trouble with police', and 'witness to violence' in the previous 12
months to the survey; in fact in this survey 77% reported experiencing such
stressors in the previous 12 months. Almost one in five Indigenous people
reported that a member of the family had been sent to jail in the previous 12
months. This of course has significant impacts on all of us.

I am particularly proud to have been involved in the development of our
strategic vision as it relates to Aboriginal and Torres Strait Islanders because
we are not seen as solely peoples with problems but people who may have some of
the answers. We say that:

‘Aboriginal and Torres Strait Islander peoples live with
historically-based, endemic whole person, whole community disadvantage. Through
a concept of health that integrates physical, cultural, spiritual, social and
emotional domains, Aboriginal and Torres Strait Islander peoples offer a
holistic perspective on wellbeing. In working to bring healing, reconciliation
and social justice to their communities, they model how to respond to multiple
and entrenched disadvantage. From their stories, we can all learn how to find
our way, acknowledge our journeys and rebuild confidence and
resilience’.

For those of you who don’t know me I am the current Aboriginal and
Torres Strait Islander Social Justice Commissioner. As part of my statutory
responsibilities in this position, I report to Parliament once a year with my
Social Justice Report which addresses the human rights of Indigenous
Australians. I also provide a Native Title Report which looks at native title
issues. I also:

• review the impact of laws and policies on Indigenous peoples

• promote an Indigenous perspective on issues and

• monitor the enjoyment and exercise of human rights for Indigenous
  Australians
  

I must admit that when I first started in this job it took me a
while to get my head around these ‘human rights’. Now people who do
know me know that I don’t say or do things that don’t make sense to
me. So with a ‘rights based approach’ now implicit in everything I
do I am on a fairly steep learning curve. But today I want to talk about how
this approach can show us a practical way forward.

Health is a good place to begin.

What was to become the intellectual
foundation of the Close the Gap Campaign: Achieving Aboriginal and Torres
Strait Islander Health Equality within a generation was first published and
tabled in the Australian Parliament as a chapter in the Social Justice Report
2005

That Report characterised Indigenous health inequality as a major human
rights issue, and called for a human rights based approach to the Indigenous
health gap.

And as a rights issue, Indigenous health inequality was largely framed as an
opportunity gap – that Indigenous peoples in Australia did not enjoy the
same opportunities to be as healthy as other Australians. That is, to see
doctors when they needed them, eat fresh food, live in healthy housing and so
on.

And this is where human rights play such an important role in providing a
sound intellectual and legal foundation for an approach to Indigenous
health.

Article 12 of the International Covenant on Economic, Social and Cultural
Rights (ICESCR) recognises ‘the right of everyone to the enjoyment of
the highest attainable standard of physical and mental health’.

The right to health is essentially the right to opportunities to be healthy:
it includes the enjoyment of a variety of facilities, goods, services and
conditions necessary for the realisation of the highest attainable standard of
health. It is not to be understood as a right to be healthy (which is
something that cannot be guaranteed solely by governments).

The right to health extends not only to timely and appropriate health care
but also to the underlying determinants of health, such as access to safe and
potable water and adequate sanitation, an adequate supply of safe food,
nutrition and housing, healthy occupational and environmental conditions, and
access to health-related education and information, including on sexual and
reproductive health.

And a key element of the idea of the right to health as the state enabling
the opportunity to be healthy, is that the sate provide equal opportunities to
be healthy to the range of sub-groups within its citizenship; and of course that
includes Indigenous Australians.

We have a human right to the same opportunities to be healthy as other
Australians.

This focus on ensuring equality of opportunity is reflected in the way the
right to health is understood, largely as set out in General Comment 14 of the
Committee on Economic, Social and Cultural Rights (that oversees State
compliance with the ICESCR)

Thus the right to health contains the following interrelated and essential
elements:

• Availability. Functioning public health and health-care
  facilities, goods and services, as well as programs, have to be available in
  sufficient quantity within a country.
  

• Accessibility. Health facilities, goods and services have to
  be accessible to everyone without discrimination. Accessibility has four
  overlapping dimensions:
  

  • Non-discrimination: health facilities, goods and services must be
    accessible to all, especially the most vulnerable or marginalised sections of
    the population, in law and in fact, without discrimination.
    

  • Physical accessibility: health facilities, goods and services must be
    within safe physical reach for all sections of the population, especially
    vulnerable or marginalised groups, such as Indigenous populations. Accessibility
    also implies that medical services and underlying determinants of health, such
    as safe and potable water and adequate sanitation facilities, are within safe
    physical reach, including in rural areas.
    

  • Economic accessibility (affordability): health facilities, goods and
    services must be affordable for all. Payment for health-care services, as well
    as services related to the underlying determinants of health, has to be based on
    the principle of equity, ensuring that these services, whether privately or
    publicly provided, are affordable for all, including socially disadvantaged
    groups.
    

  • Information accessibility: includes the right to seek, receive and
    impart information and ideas concerning health issues. However, accessibility of
    information should not impair the right to have personal health data
    treated with confidentiality.
    

• Acceptability. All health facilities, goods and services
  must be respectful of medical ethics as well as respectful of the culture of
  individuals, minorities, peoples and communities, sensitive to gender and
  life-cycle requirements, as well as being designed to respect confidentiality
  and improve the health status of those concerned.
  

• Quality. As well as being culturally acceptable, health
  facilities, goods and services must also be scientifically and medically
  appropriate and of good quality.
  

And I’m sure as I’ve set out these elements of the
right to health in relation to health services, you can see immediately how the
right itself if of enormous assistance to Indigenous Australians; recognising
the importance of culturally tailored services, for example, in ensuring that we
are able to access health services.

In the preamble to the United Nations Declaration on the Rights of Indigenous
Peoples the UN General Assembly:

Affirmed the Indigenous peoples are equal to all other people and while
recognising the right of all people to be different, to consider themselves to
be different, and to be respected as such.

The onus for dealing with that difference falls on the providers of services.
It is not for the person to navigate his or her way through a health or any
other system. It is the duty of the system to be built in such a way to deal
with differences.

To take this concept further I suggest we have to look to the standards
contained in the UN Declaration on the Rights of Indigenous Peoples, the
instrument that contains the minimum standards for the survival, dignity and
well-being of indigenous peoples.^[1] And in essence these standards are about creating better engagement between
States and Indigenous peoples.

This Declaration took over 20 years to develop with both States and
Indigenous peoples being involved.

When it was adopted in 2007 an overwhelming number of States voted in favour
with only four voting against. These four included Canada, New Zealand, the
United States and Australia.

In 2009, Australia, was the first of these four to reverse position, closely
followed by New Zealand. I am pleased to report that the remaining two, Canada
and the USA have also indicated they are looking to reverse their positions on
the Declaration.

Although only a declaration and therefore aspirational, this instrument is one of the most significant milestone in the protection of indigenous
human rights. In one place it catalogues the human rights outlined in other
binding international instruments as they apply to indigenous peoples. In that
sense it is sourced from binding international law like the Convention on the
Elimination of All Forms of Racial Discrimination should apply to indigenous
peoples.^[2]

It is crucial to grasp a central tenant of the Declaration, namely the
importance of re-setting relationships between Indigenous peoples and the
broader community but more particularly governments. In other words better
engagement. The Declaration in affirming Indigenous peoples collective rights to
self-determination and decision-making powers through the principle of free,
prior and informed consent, is not an instrument of division, rather an
instrument to create the institutional structures, arrangements and process
needed for indigenous peoples to be able to effectively engage in a relationship
with Governments based on mutual respect. Any doubt to this is made clear in the
preamble which states the General Assembly is:

Convinced that the recognition of the rights of indigenous peoples in this
Declaration will enhance the harmonious and cooperative relations between the
State and indigenous
peoples.^[3]

I will dedicate my work to February 2014 to reframing the relationships
Aboriginal and Torres Strait Islanders have at four levels in Australian
society.

The first level will be with the rest of Australia and this will involve
constitutional change and addressing issues like racism. I will come back to
this constitutional matter later.

The second level will be with Government, both nationally and with
communities.

The third level will be at the international level where we join with other
Indigenous peoples globally to pursue our rights with Governments of the world,
but to also bring those outcomes back to Australia and agitate for their
implementation domestically as a way of making headway to addressing the issues
we face on a day to day basis.

The fourth level will be addressing the relationships between Aboriginal and
Torres Strait Islanders at the individual, family, organisational and community
levels. This cannot be a Government program because these are our issues to
sort out.

The full implementation of the Declaration will therefore form the basis of
my work for the duration of my tenure.

I finally want to return to the issue of constitutional recognition of
Aboriginal and Torres Strait Islander peoples. During the recent election
campaign both major parties committed to a referendum to facilitate such
recognition. In my view Australia will go to a referendum at the next election
in three years time with a question, at the very least, about preambular
recognition.

There is plenty of work to do bringing together a group of people from the
wide spectrum of Australian society who will campaign for this change and to
develop the thinking about the extent of change to be put to the Australian
people.

Now we don’t underestimate the difficulties we will all face in this
endeavour. For instance, only eight out of 44 referenda have been passed in
Australia’s history because there is a double majority needed. First
there needs to be an overall majority vote yes, and secondly 4 out of the 6
States also have to vote yes.

In real terms this means about 14 million people we need on our side.

We also know that bipartisan support at the political level will be
absolutely essential and I am pleased to see the Greens and the Independents
also indicate this matter will be a priority.

I think we can look at the referendum in two ways. One, it will mark the
beginning of a new relationship between Aboriginal, Torres Strait Islander
peoples and the rest of Australia. Or it will be the end point to say we now
have a relationship built of mutual respect.

For me I will be going for the second option, because we need to have the
majority of Australian onside if the referendum is to be successful. We will
need their vote in three years time and for me that says we need to start this
relationship building right now, from today onwards

One of the great attractions to this is that it will be this generation that
gets the opportunity to say ‘yes’ and same opportunity that
generation had in 1967. And imagine being able to say to our grandkids, that it
was us that did this great thing. That we put the final part of the jigsaw in
place the finally gave recognition to the first peoples of Australia.

I would say it is an opportunity we cannot afford to miss, so therefore we
have less than three years to do all of the hard work.

I want to finish with
a poem form Oodgeroo, or Kath Walker, one of the heroes of our struggle. It is
for her son Denis and for me it captures the essence of change needed here. It
goes like this:

My son, your eyes search mine

Hurt and puzzled by colour line

Your
black skin as soft as velvet shine

What can I tell you son of mine

I could tell you of heartbreak, hatred blind

I could tell of crimes that
shame mankind

Of brutal wrongs and deeds malign

Of rape and murder son of
mine

But instead I will tell of brave and fine

When lives of black and white
entwine

When men, in brotherhood combine

This I would tell you son of
mine

Thank you ladies and gentlemen

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^[1] United Nations Declaration
on the Rights of Indigenous Peoples, GA Resolution 61/295, UN Doc: A/61/L.67
(2007), article 43.

^[2] See
Committee on the Elimination of Racial Discrimination, Concluding
Observations on the United States of America, UN Doc CERD/C/USA/CO/6 (2008),
para 29. At http://www1.umn.edu/humanrts/CERDConcludingComments2008.pdf (viewed 20 January 2010).

^[3] United Nations Declaration on the Rights of Indigenous Peoples, GA
Resolution 61/295, UN Doc: A/61/L.67 (2007), preambular para 18.