Indigenous people

Introduction

Rates of homelessness among Indigenous people across Australia are higher than among the non-Indigenous population. Indigenous homelessness is also significantly higher in rural and remote areas. The 2005/06 SAAP National Data Collection annual report found that 17% of SAAP clients identified as being an Aboriginal and/or Torres Strait Islander, with 21% of all female SAAP clients identified as being Indigenous and 12% of men. The Northern Territory and Western Australia had the highest proportions of Indigenous client contacts — 63% and 41% respectively (Australian Institute of Health and Welfare, 2006). A distinction needs to be made between Indigenous people living in metropolitan areas, those in regional and remote centres. See the information sheet on rural/regional people with AOD problems for an overview of additional issues that can be taken into account for clients in regional areas.

Issues to consider when providing assistance

The following points need to be kept in mind when providing outreach assistance to Indigenous people who appear to have alcohol and/or other drug related problems.

• ‘Homelessness’ as a concept may not have the same meaning to an Indigenous Australian as it does to a non-Indigenous Australian, where, for example, sleeping outside is considered in some Indigenous communities to be an accepted cultural norm and part of social bonding. In such instances, encouraging Indigenous individuals to present themselves to supported accommodation may not be appropriate, particularly if the individual is in the company of other Indigenous people. The questions therefore are:
  • What support networks does the individual have?
  • Do they consider themselves homeless; and,
  • What other needs do they have?;
• Drinking in public places and in groups can be a cultural norm in some communities and part of the process of social bonding. In the case of group-based drinking, it is not recommended that outreach workers who are not familiar with the individuals intervene;
• Due to a long history of inequalities and racist treatment, and also due to cultural diversity, it is preferable that workers responding to the needs of Indigenous people, particularly those in groups, are approached by Indigenous caseworkers, or at least workers who have experience in working with Indigenous client groups. It is recommended that staff of Indigenous health services, Aboriginal Land Councils and (where operating) Indigenous Night Patrols are contacted. [provide link to database here]
• If staff from the above services are unavailable and harmful or aggressive behaviour is encountered among Indigenous people, it is recommended that police are contacted.

Issues to consider in assessment and referral

• While more Indigenous people abstain from alcohol than in the general population, about half of Indigenous drinkers consume alcohol at risky levels and alcohol-related harms, including deaths, are proportionately higher among Indigenous people;
• The mainstream understanding of homelessness may not serve Indigenous people well. For Indigenous people not having accommodation does not always constitute homelessness. It is important that you clarify the situation as opposed to making an assumption. It will be important to ascertain access to and support from the broader family and community network;
• Treatment programmes need to be culturally secure in order to support the specific needs of Indigenous clients. This can be addressed in a number of ways:
  • Ensure that staff are trained in identifying and responding to the needs of Indigenous people;
  • Ensure that management policies and procedures create a culturally secure environment;
  • Consider employing Indigenous staff — if you do so, it is important to ensure they have good support and work in a culturally secure environment; and
  • Liaise with Indigenous services to provide support to your staff, to provide effective case management and referral and to identify specific issues that may need to be addressed in your region. Some services may be able to offer you advice on how to develop a more culturally secure service.
• Some Indigenous clients may have difficulty understanding the requirements of your programme as there may be language and communication differences. Staff training and liaison with Indigenous services and expertise can help address this;
• Some Indigenous people may not be comfortable participating in group activities. Liaise with local Indigenous expertise to identify how best to develop and implement a service that is culturally secure;
• Some Indigenous people may not be comfortable with being in confined space and having their own room may be confronting, especially if they have spent long periods of time sleeping outdoors;
• Some Indigenous clients may be uneasy if there is someone they know who works at the centre, or if there is someone he/she knows receiving treatment at the time. It is important (as always) to adhere to confidentiality procedures in order to reassure clients that this will not be breached;
• Clients may feel lonely, and isolated from their community and/or social group, which may have a negative impact on treatment compliance. It can be useful to identify and liaise with services that can provide support to the whole family and community network. It will be important to identify the capacity of local and regional services to respond to the varied needs of Indigenous people in your region;
• For organisations that assist Indigenous people into treatment it is particularly important to ensure that the client will meet the programme’s entry criteria, before discussions are held with the client. It needs to be explained to clients that the arrangements can take some time to make and that sometimes there may be a waiting period before treatment can begin. It will be important to identify and refer to services that have developed culturally secure procedures and practices; and
• The Indigenous population is not homogenous. It is diverse in terms of language, culture and where and how its members live. This is why it is important to ensure that effective staff development programmes are implemented and that you have liaised with local expertise and Indigenous services to ensure you meet local needs.

Summary

To summarise, it is advisable to take the following steps:

• Ensure staff are trained to respond effectively and in a culturally secure manner to Indigenous clients;
• Create effective networks with service providers who have expertise in responding to Indigenous people – they may be able to provide training, advise on protocols and procedures and help establish an effective referral network and pathways;
• Consider employing Indigenous staff and, if you do, ensure they are well supported;
• Determine if you are able to offer a culturally secure service — if not, identify and establish effective referral pathways to services that can;
• Consider the specific needs of Indigenous people:
  • Do you have good links to Indigenous services such as an Aboriginal Medical Service, or Aboriginal Legal Service?
  • Do not make assumptions based on your experience outside Indigenous communities (e.g. you may need to re-define your understanding of drinking patterns, homelessness and family dynamics and networks);
• Consider and identify strategies to respond to problems of confidentiality and conflict of interest, especially in small and related communities;
• Consider the needs of the broader community and family networks.

A list of resources and contacts for Indigenous specific services is provided in the Alcohol Treatment Guidelines for Indigenous Australians by the Commonwealth Department of Health and Ageing at http://www.alcohol.gov.au.

Source

The information contained in this guideline sheet has been sourced from interviews with homeless people, focus groups with practitioners, consultation with experts in the field, and a review of homeless studies undertaken by researchers at the National Drug Research Institute, Ted Noffs Foundation and St Bartholomew’s House for the Australian National Council on Drugs in 2007. The following references were cited in this information sheet:

Australian Institute of Health and Welfare. (2006). Homeless people in SAAP: SAAP National Data Collection annual report 2004–05 Australia. AIHW cat. no. HOU 132. Canberra: AIHW (SAAP NDCA report. Series 10). http://www.aihw.gov.au/publications/index.cfm/title/10419.