To change the nation, we also need to change ourselves.

28 Jan 2020

Changing the nation requires us blackfellas to also do our bit, and in the prevention of suicide among our mob it’s an important bit. But we must be on the same page. This means no longer treating mob as if they are not worthy of clinical interventions that everybody else has access to. This means no longer excluding Indigenous clinical expertise from the conversation.

Dameyon Bonson

 

Preventing Indigenous suicide is just one cog in a much bigger wheel of much needed change, but arguably one the most critical issues facing us as Indigenous people.

Having worked both regionally and remotely in Indigenous suicide prevention for a few years now, both as an employee and as a private practitioner (non-therapeutic program design and delivery, plus attached to a couple of research projects) now with a post grad certificate in suicide prevention under my belt and into the second year of the Master of Suicidology (yes, I’ve given you my CV) which kicks off next month, I’m observing an ongoing and apparent allergy to Indigenous solutions with clinical utility.

One of the greatest challenges to preventing suicide is to understand the ‘why’. Suicide, including deaths by suicide, attempts and non-suicidal self-harm, are behaviours. So, seeking out ‘why’ some of our mob engage in behaviours that ultimately lead to their death is important. Often, when a person dies by suicide a psychological autopsy is undertaken in an attempt to determine the ‘why?’. But, even with psychological autopsies the reason(s) ‘why’ can remain elusive as they involve a backwards look into a complex set of human behaviours reactive to what ultimately remains unknown and that rely on the subjective observation of others. As human beings we are as complex as we are different and therefore it can be strongly argued that in determining the ‘why’ of person A who has died by suicide can have limited applicability in the prevention of the suicide of persons B, C and D. From my experience, in trying to better understand the ‘why’, we need to look at the level of suicide risk in the living and this can only be done in the first instance with assessment for an immediate response and then later coupled with large-scale research. Ultimately, to combat the escalating rate of suicide amongst our mob we desperately need to be getting assessment right – and by right, means to be both clinically and culturally valid.

Assessment leads us to the ‘why’. It brings us closer to preventing it. But it’s getting ignored and that should be a concern for us all.

Colonisation as cause is also unhelpful. Those who speak of it offer up nothing substantive, giving us nothing to use to effectively respond to suicide in our communities.

Its vague and damaging to the discourse.  Purporting colonisation as cause for suicide among our mob exceptualises Indigenous suicide to be unique. That the behaviour is unique. Suicide doesn’t not discriminate. It is not unique. The risk factors may be different, but the behaviour is human.

In 2019 we again saw support given by Indigenous leadership, Government, and politicians, to the adaption of yet another mainstream assessment for depression. This is followed by decades of adapting culturally biased mainstream (white) approaches to determining the cultural factors specific to Indigenous suicide risk and yet the suicides continue to rise. Unsurprisingly its these same leaders who author report after report and line up recommendation after recommendation, all to the exclusion of substantiative Indigenous clinical contribution and contributors. Looking a little deeper this makes sense as you find that the relevant clinical and cultural suicide prevention skill set, and expertise is lacking from many of these authors themselves. Folks, at last check we have an estimated 100 practicing Indigenous psychologists alone in this country, so why is that? The kicker, those advising government are also the same folks the government gives money too and millions of it. The result? Indigenous clinical and culturally validated prevention remains absent in the research, the responses, the treatments and the assessment tools. This is not best practice. This behaviour will not prevent these tragedies confronting our people.

Serious question, are the lives blackfellas that insignificant that we are not worthy of such an investment and engagement beyond a handful of individuals? That we are we not worthy of Indigenous clinical and culturally validated best practice in research, treatments and assessment tools? Do our lives even matter?

I can’t help but think what message the exclusion of Indigenous clinical contribution gives to aspiring or established Indigenous psychologists, suicidologists and others of similar pedigree, “Err, sorry, your degrees and post graduate studies aren’t worthy here”? Or my favourite, the idea that because you’ve gone and gotten yourself an education that somehow you aren’t “grass roots” enough. The implication that you are somehow no longer black enough. Yeah. In the bin.

Folks, there is also this idea being pushed that suicide didn’t exist pre-contact, that it wasn’t part of our traditions or culture. This highlights a significant lack of understanding and comprehension of suicidal behaviour by those providing this kind of commentary. Suicide is a human behaviour. The risks may be greater, and cause may be different to that pre-1788, and most certainly the number of deaths by suicide appear to be higher, but you simply cannot claim that it did not exist.

Changing the nation requires us blackfellas to also do our bit, and in the prevention of suicide among our mob it’s an important bit. But we must be on the same page. This means no longer treating mob as if they are not worthy of clinical interventions that everybody else has access to. This means no longer excluding Indigenous clinical expertise from the conversation. No more cherry picking. Suicide doesn’t care if your black, white, brown or brindle and we are simply losing way too many. Straight up. Ignoring Indigenous clinical practice is as close to being complicit in the suicides among our mob as you can get. To change the nation, we also need to change ourselves.

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