Addressing gambling in Indigenous communities: Embracing community, diversity and wellbeing

Content type
Webinar
Event date

29 September 2015, 1:00 pm to 2:00 pm (AEDT)

Presenters

Marisa Fogarty, Nicola Coalter, Ashley Gordon, Helen Breen

Location

Online

 

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Gambling affects Australian Indigenous families and communities in diverse and complex ways, but to date there has been a lack of coordinated research, service delivery or policy focus in this area. This is partly due to the variety of Indigenous peoples’ gambling practices, as well as the diversity of the contexts in which Indigenous people live.

This webinar described this diversity and discussed the relevance of applying a health promotion framework to address the issues related to gambling in the Australian Indigenous context. The presenters discussed the five key areas of action of the Ottawa Charter (1986) on health promotion, and analysed how this framework can be used to guide policy and practice.

The webinar drew upon the available research literature and the extensive knowledge gained from gambling service delivery in the Northern Territory and New South Wales.

This event was presented in partnership with the Australian Gambling Research Centre.

Audio transcript (edited)

Webinar facilitated & speakers introduced by Associate Professor Daryl Higgins

Higgins

Well good afternoon everybody and welcome to today's webinar on the topic of addressing gambling in Indigenous communities: Embracing, community, diversity and wellbeing. The seminar is presented by the Child Family Community Australia Information Exchange and the Australian Gambling Research Centre, both here at the Australian Institute of Family Studies. My name is Daryl Higgins and I'm the deputy director here at the institute. Today we will hear about the diverse and complex ways gambling affects Indigenous families and communities, and the relevance of applying a health promotion framework to address the issues related to gambling and Indigenous content.

And we're also going to be looking at the relevance of applying a health promotion framework to address the issues related to gambling in the Indigenous context, as I said. We're going to be drawing on the extensive knowledge gained from gambling service delivery in two of our states and territories, the Northern Territory and New South Wales, and this is really important for us because as you know, we've established the Australian Gambling Research Centre here at the institute and it's been in operation since July 2013.

It provides high quality evidence-based publications and resources to increase the capacity and capability of policy makers, researchers and professionals working in the gambling sector, focusing particularly on understanding the harm that's caused by gambling to problem gamblers, their families and community members, and those at risk of experiencing harm and looking at measures that can be undertaken to reduce harm, and, of course, statistics and data on recreational gambling as well. In that context it's a great partnership between the Australian Gambling Research Centre and the CFCA Information Exchange to present this webinar today.

But before I go on and introduce our speakers, I would like to acknowledge the traditional custodians of the lands on which we're all meeting here in Melbourne and around the country, and pay respects to the Wurundjeri people of the Kulin Nation here and to Elders past and present from all of the communities around the country where each of you are participating today. It's now my great pleasure to introduce the three speakers that we have today.

The first speaker is Dr Marisa Fogarty, who's a post-doctoral fellow at the Australian National University Centre for Social Research and Methods. Marisa has a PhD in Anthropology from Charles Darwin University and a Masters in Applied Anthropology and Participatory Development from ANU. Following Marisa will be Nicola Coalter, who's a registered psychologist currently undertaking a Masters in Public Health and works as the coordinator of Amity’s Territory-wide gambling project, and we're looking forward to hearing about that.

And finally Ashley Gordon is an Aboriginal Australian from the western New South Wales community of Brewarrina. I hope I've pronounced that correctly, Ashley, a descendent of the Gamilaroi people. Ashley has been a gambling counsellor for 7 years and is now a fulltime Aboriginal gambling consultant. While Dr Helen Breen wasn't able to join us today, 
she has also contributed to part of the presentation today and she's an adjunct research fellow with the Centre for Gambling Education and Research at Southern Cross University.

So just a couple of housekeeping things before we go on. As I mentioned, of course, CFCA has a real focus on sharing information, and I would like to remind everyone that you can submit questions today via the chatbox function on your webinar and we'll allow a short amount of time at the end of the presentation to try and respond to as many of those questions as possible, so please start sending those in as soon as you think of the question.

We also want to continue the conversation beyond the 
one-hour webinar and so to facilitate this, we've set up a forum on the CFCA website where you can discuss the ideas and the issues raised, and submit additional questions after the conclusion of today's webinar. We'll send you a link to that following the webinar. Please also remember that the webinar is being recorded and the audio and transcript and the presentation slides will be made available on the website and the YouTube channel in due course. Accessible versions will also be available. So that's enough from me. I'd like you to join me in welcoming each of our presenters in a very warm virtual handclap welcome. So first up, Dr Marisa Fogarty. Thank you, Marisa.

Fogarty

Hello, thank you very much, Daryl. We would like to start today's presentation by saying thank you very much to the Australian Institute for Family Studies, specifically the CFCA Information Exchange and the Australian Gambling Research Centre, for working with us to present these ideas today. We see this webinar as a really significant opportunity to present a structured framework to begin to address gambling issues in Indigenous communities that has relevance across jurisdictions. As much as we are highlighting what has been done and what knowledge we do have, it is also intended that this webinar will highlight where the gaps are and what work needs to be done in this area. So we would like to thank everyone for joining us today.

We would like to acknowledge the traditional custodians of this land and in particular I'm talking from the ACT so I'd like to acknowledge the Ngunnawal people and pay respects to Elders past and present. As Daryl outlined, today these are the authors of this presentation. Dr Helen Breen was unable to join us, so I will be reading her part of the presentation, which I will let you know what part is hers.

So, gambling is an activity that impacts on Indigenous families and communities around Australia in diverse and complex ways. To date, there has been a significant lack of coordinated research, service delivery and policy focus in this area. This is in part a result of the diversity of Aboriginal people's gambling practices. For example, across the remote north and central areas of Australia the predominant gambling activity is unregulated card games, whereas the gambling activities of people living in urban and regional areas is much more focused on poker machine gambling.

There is also the issue of the diversity of contexts in which Aboriginal people live around Australia. For example, the service and policy needs of people living in very remote areas of Australia will differ significantly to the needs and realities of Aboriginal people residing in large urban centres. This webinar will address this diversity and discuss the relevance of applying a health promotion framework to address these issues related to gambling in the Indigenous context in Australia. We will discuss the five key areas of action of the Ottawa Charter on Health Promotion and analyse how this framework can be used to guide existing policies, guidelines and strategic directions.

It is the central premise of this webinar that these areas of action, these principles, are framed in collaboration with communities around the way in which Aboriginal people do gamble and the broader social context of people's lives. Doing so will create opportunities for community engagement and community-driven sustainable actions for promoting the health and wellbeing of Aboriginal families and communities.

So just to give you an overview very quickly of what the research suggests. The Australian Aboriginal and Torres Strait Islander Health Survey found that about 8 per cent of Indigenous people reported gambling as a family stressor in their survey. In the Longitudinal Study of Indigenous Children Wave 3, 26 per cent of primary carer respondents to the survey reported that either they or a close family member had a gambling problem. That survey also found that irrespective of remoteness, Indigenous people were unlikely to engage with gambling help services. Other research suggests that Aboriginal people experience problems at two to five times the rate of the general population across all states and territories. That particular study used the NATSISS, the National Aboriginal and Torres Strait Islander Social Survey, which you can see the estimates of reported gambling problems in the table on the slide.

So what we want to introduce today is a health promotion framework. Health promotion is a particular discourse within a public health paradigm that aims to promote and improve the health of individuals, communities and whole populations through empowering participatory approaches. In Australia, there has been increasing commitment and investment, particularly at state and territory levels, in adopting health promotion frameworks. There is also increasing evidence of the effectiveness of the adoption of a health promotion framework to address Aboriginal and Torres Strait Islander health issues in Australia. The 2012 Scoping Study of Health Promotion Tools from Lowitja Health Institute looked at the evidence of a health promotion framework in the Aboriginal and Torres Strait Islander field and they found that community-driven well-designed and implemented health promotion does result in improved health in Aboriginal and Torres Strait Islander communities.

Today we're going to present the health promotion principles in relation to Indigenous gambling issues. The five key principles for action that we're going to look at are building healthy public policy, creating supportive environments, strengthening community action, helping people develop skills and reorientating health services. So the next part of this presentation is going to be Dr Helen Breen's, which I will be reading for you today. Helen wanted to acknowledge the research team at the Centre for Gambling, Education and Research at Southern Cross University. She also wanted to acknowledge the cooperation and collaboration of many Aboriginal people, as it is very much appreciated and was the foundation for this research. Funding was received for this research from the Australian Research Council Discovery Grant and an Australian Postgraduate Award.

So the central tenet of building healthy public policy. This principle of a health promotion approach places a population's health and wellbeing at the centre of all public policy creation. All public policy development must consider its impact on a population's health. This principle requires identifying impacts, risks and barriers likely to prevent the adoption of healthy public policies and find ways of reducing or even removing them. Finally, building healthy public policy relies on adequate resource decisions. This principle recognises the cost effectiveness of health promotion strategies and should support them through funding. Providing resources for health promotion programs that target particular topics, such as consumer protection for gamblers and the prevention of gambling related problems, should ultimately reduce expenditure on treatment services and rehabilitation.

So, why building healthy public policy is important for Aboriginal people with gambling issues. Moving now to the topic of our presentation, it is important to explain the underlying rationale. One size does not fit all. Aboriginal populations appear to face higher risks with their gambling than non-Aboriginal populations. Risks and barriers for building healthy public policy do exist. For example broad cultural diversity, large family kinship groups and cultural responsibilities, younger populations and increasing numbers of younger people, and also small group numbers in geographically sparse areas, urban and remote diversity, and the impact of structural issues such as structural disadvantage, historical discrimination, unequal opportunities for education et cetera.

How does this relate to gambling? Gambling is a popular acceptable social activity that can produce positive and negative outcomes. Card gambling in Aboriginal communities has lengthy, historical, social and cultural foundations for many Aboriginal families. But Aboriginal gamblers seem to use commercial gambling, especially poker machines, much more now and to a much greater extent than the general Australian population. Research suggests that the implication of frequent, regular, high intensity gambling by people with a disadvantaged background is that gambling related harms are common but often kept hidden. Shame and stigma are associated with disclosure about gambling problems, but the harms include a lack of money for daily needs, stress, arguments, troubled families and poorer communities. So a reduction of general health and wellbeing of individuals, families and communities is felt when gambling harm is experienced.

What are the implications for public policy? The crux of the matter is we don't have much basic evidence in this area on which to base healthy public policy. That is why using this health promotion approach is particularly useful because it provides a framework to work within to develop policy in this area of gambling, and the impacts on families and communities. What we can identify and explain is the risks associated with gambling by Aboriginal people. People recognise and describe these risks as seen within their families and communities.

So let's begin with the definition of risk. Risk is a position where a person is exposed to the likelihood of experiencing an adverse or undesirable outcome. Further, a risk factor is a variable associated with increased chances of facing undesirable outcomes. For example, the risk of losing money by gambling on poker machines is high for all gamblers but a risk factor for an Aboriginal gambler might be the expectation of winning money based on culturally acceptable card gambling experiences where winnings mostly remain in family groups or communities.

So who faces risks with their gambling? Most Aboriginal people who gamble face some risk. The research that Helen conducted surveying over 1,200 Aboriginal people at three Aboriginal and Torres Strait Islander sports and cultural festivals found that almost half of all research participants, and nearly two-thirds of all gamblers, face some risk with their gambling. Some of these risks factors included older people, those always exposed to adult gambling when children, and those with family and friends who gamble. In this context, generational influences are very important.

So who engages in high-risk behaviour with their gambling? Those people who start gambling when younger, under ten years, those who gamble regularly, those who gamble on multiple forms, those who spend more than $100 on their favourite gambling form each fortnight, and those who consume alcohol and/or drugs while gambling. Regular, frequent, high expenditure gambling accompanied by alcohol and/or drug use is high-risk behaviour.

So what about risk factors? Helen's research has identified three common sets of risks that have been associated with gambling motivations, gambling products and gambling consequences for Aboriginal gamblers. Firstly, the motivations to gamble: a belief in winning, a belief, a system or strategy can lead you to win and reduce poverty, for example; to escape; it helps people to relax; it reduces stress, depression, and general cultural influences, historical attitudes and beliefs about gambling, reciprocal obligations et cetera. Access to gambling is another factor – so easy physical and social access to both card games and commercial gambling. And the consequences of gambling – poverty, shame and stigma and a reluctance to seek gambling help – are all risk factors.

For balance, Helen's research has also looked at identifying protective aspects of gambling by Aboriginal people. So protection is the action a person takes to preserve their life and wellbeing. Protective factors increase a person's ability to resist the pull of a risk. Protective factors are flexible, they can accumulate and their accumulation can lead to resilience. Importantly, protective factors associated with card and commercial gambling are mostly cultural, thus valuable and important for Aboriginal people as demonstrated.

Engagement with collective culture. Aboriginal society is characterised by close, dense and extensive networks. These are a protective factor – this cultural relatedness based on strong Indigenous kinship groups. Cohesion in these cultural networks and resilience grows from this as well. Individual social group and controls – these are another protective mechanism. Some people set gambling limits with budgets. Self-control and group self-regulation are all protective mechanisms. Role models, parents, siblings, extended family – all provide positive examples. And religious beliefs is also a protective factor because it discourages some people from gambling.

So in conclusion, Aboriginal family networks, cultural values and social relationships appear to have enduring power in helping to spread awareness, managing to assist in preventing various harms while protecting some gamblers from gambling risks. This is an important, appropriate and valuable resource to be harnessed to contribute to building and resourcing healthy public policy for Aboriginal people who gamble.

Now in the presentation we're going to move onto my part that I'm going to talk about today. Two of the principles that I have looked at, health promotion principles, are developing personal skills and creating supportive environments. Korn and Schaffer, who wrote one of the most influential papers on adopting a public health approach to gambling, defined the rationale behind the Ottawa principle of developing personal skills as focusing on developing individual skills in the areas of decision making, self-monitoring, intervention, to make balanced inform choices in relation to gambling.

However, when working in the Indigenous context, for health population to be successful, the approach needs to resonate with Indigenous understandings of health and wellbeing. So in today's seminar, we're going to define health as the National Aboriginal Community Controlled Health Organisation defines Aboriginal health as meaning not just the physical wellbeing of an individual but it also refers to the social, emotional and cultural wellbeing of the whole community. It's a whole-of-life view and includes the cyclical concept of life-death-life.

So a holistic development of skills. To adopt this understanding of Aboriginal health in relation to health promotion, it needs to be holistic. This is outlined in the slide in the model. That is, that central to this principle is incorporating Indigenous knowledge and understandings. So how we work with that knowledge and understanding is really about adopting a strengths-based approach and identifying different skill sets and requirements for building social wellbeing at the individual, family and community levels.

A strength-based approach is really about shifting the overall focus away from the deficit or the problem or pathology of an individual in relation to gambling – so instead it's about embracing strengths principles. That is, that every individual, family group and community has strengths, and focusing on these strengths rather than pathology, that the community is a rich source of resources, that interventions are based on 
self-determination, collaboration is central and essential, and a belief that all people have the inherent capacity to learn, grow and change.

What is really central to this understanding of developing skills and empowering people is, as Helen said, through the development of skills and the promotion and support of strengths and protective factors. So looking at the incorporation of Indigenous understandings of gambling, the central premise to holistically developing skills is the incorporation of Indigenous understandings and context into every part of a health promotion approach. This is really what I see as the ethical underpinning of applying this approach. A very clear example of this is understanding, incorporating and working with Indigenous understandings of when gambling becomes a problem.

Ethnographic research that I conducted in the Northern Territory found that mainstream notions of time or money spent gambling were not central to Indigenous people's views of problem gambling. This is not to say that people did not experience problems as a result of losing their money or spend detrimental amounts of time gambling. People did. However, the research found that a problem was perceived in how the individual had responded and treated others around them. So Aboriginal people defined a person as having a gambling problem as a person neglecting or rejecting social relationships and obligations as a result of their gambling. 
The research found that problems with gambling were most often identified by Aboriginal people when the gambling became individuated. That is, when an individual began to attend card games or gambling venues by themselves or not play within accepted social structures, or it was when people were seen to be neglecting their obligations in terms of sharing their winnings, for example.

Important understandings about gambling also come from understanding money and how Indigenous people use and incorporate cash into their everyday lives, understanding that cash is a shared commodity. Particularly across the north of Australia, cash has been adopted into community life in culturally unique ways, and gambling, particularly card games, have a very prominent role in the distribution of cash in households and communities. So what does developing skills look like?

Well to give you an example, in education and awareness in particular, developing resources for community health and education services, community organisations and institutions, to educate and develop skills in understanding and addressing gambling issues. Developing guidelines for best practice and service delivery to address gambling and the impacts on Indigenous families and community in culturally appropriate ways. Another suggestion is developing resources within communities for communities to address gambling issues – for example, community guidelines for safe gambling. So having a multi-level multi-service approach, working simultaneously at individual family and community levels is really the crux of building and developing skills.

The second principle that I want to talk about today is about creating supportive environments. There's many levels to this principle as well, and it goes to the physical health of people's households and communities. But in particular what I want to focus on today is looking at how you create safe, supportive, appropriate gambling help services. That first point is the way that these supportive environments have presented around Australia is at the moment very different in different jurisdictions. There are many different approaches in different states to addressing Indigenous gambling issues and they really are quite significantly different, but there's a lack of research and a lack of evidence in this area of what constitutes best practice, what does work, what doesn't work in Indigenous gambling service delivery. A large part of the development of a supportive environment is reflected in the cultural competency of a service or organisation. So again, there's a lack of constructive guidelines to inform culturally appropriate gambling service delivery in Australia.

The other sort of more broad aspect of creating supportive environments that I want to discuss today is basically broadening the domain when looking at a community, town or city as a whole environment, with multiple resources available to address gambling. For example, schools, health clinics, early childhood centres, women centres, police services, businesses. So really looking at gambling and addressing gambling at a much broader level. There's a significant amount of expertise and resources that already exist within all these organisations and communities

So it's about engaging the people that work in these areas and educating people about gambling. That way it begins to build a supportive environment. Again it's counselling services, gambling helplines, financial counselling, parenting programs, diversionary programs, school programs. These all exist to some capacity at the moment and so it's about presenting people with these services in an accessible package, and letting people know that they are supported in this. A huge part of this is really about creating self-sustaining supportive environments to address gambling issues, because, particularly in the really remote areas, the cost and the logistics of, you know, address gambling in these areas is significant, so we need to think more broadly about the environments that we're working in. Now I'm going to go to Nicola from Amity Community Services, who's going to discuss the principle of reorientating health services, so thank you.

Coalter

Thanks, Marisa. I'd just like to kick off with a little about us here at Amity and the places that we work around the territory, and then talk about action research and continuous improvement to change the direction of some of our service delivery around gambling. Amity has been working in the area of problem gambling and gambling for over two decades. Our program is underpinned by the public health model and works predominantly in the areas of intervention and prevention. We've been involved in the field of harm minimisation and community education, and training and development for over four decades. We espouse a public health view to gambling issues throughout the territory and we acknowledge the existence of gambling and its related problems arising from a complex interaction between the games people play, the individuals and the factors within the individual that contribute to the desire to gamble and the socio-political, environmental or systemic factors that might impact or encourage or discourage people to gamble.

The priorities for our service delivery are around prevention, education and intervention services. We try to stimulate community awareness and we work collaboratively to develop a range of public health campaigns. We engage in community development projects focused on building community resilience. We facilitate information about the nature of behaviour and change for people and for communities. We work to enhance health literacy outcomes and promote the adoption of healthy habits and lifestyles. We also like to participate in research.

We began receiving requests from a range of people throughout the territory and as a part of our commitment to continuous improvement. We reviewed and further looked at our programs and practices. We're engaging in a lot of community education, brief interventions and face-to-face counselling driven by appointments, and we could recognise that we were missing a whole range of people from a whole range of places throughout the territory.

This is where we work. Regulated and unregulated gambling activities have long been part of the social and cultural fabric of the Northern Territory. Similar to other states and territories in Australia, the territory has had a long association with gambling. Gambling is thought to have been introduced to Aboriginal communities through contact with Asian traders who frequented the north Australian waters, then later through the arrival of Europeans and through the Afghan camel drivers in central Australia. Horse racing has held a prominent position in cultural and social fabric of the community since European settlement. Race meetings were well attended by a cosmopolitan population as early as the 1870s.

The territory has a vast land area of 1.352 million square kilometres; however, its small population means it has the lowest population density of any state of territory. Here in greater Darwin, we have a population of about 128,000 people, which constitutes half of the territory's population. Alice Springs located 1,500 kilometres south of Darwin has about 27,000 people. The estimated population of the territory is about 241,000 people of which 30 per cent are estimated to be Indigenous people. Our experience has shown us that working with a systems approach offers the greatest opportunity to identify, develop and deliver services that directly and indirectly work to reduce the harms associated with gambling.

We work from an action research framework. In 1944, Lewin coined the term and described it as research leading to social action. Action research is a practice that enables us to explore a series of steps composed of cycles of planning, action, fact finding about the results of our action. Our planning for this particular service delivery came about as a result of people telling us that they were worried about gambling in their community. This case example is from 2007. We planned to go and learn about the community's experience of gambling. Through identifying and informing and organising our work, we thought about how we could work together for sustainable gambling interventions in communities that are very often far away from our offices.

We had a range of requests from people and services and communities, and through these requests, we worked to developed partnerships and develop a workshop in a central location in the desert in Alice Springs. This workshop was aimed at attracting a diverse range of health workers, Indigenous and non-Indigenous, and through the experience, the group who participated also worked on a strategy to inform their actions. The strategy and stories were painted onto a canvas. This vision was about working to minimise harms and create discussions around safer gambling. Together we explored the nature of chance and luck, how gambling happens in the community, how gambling was hurting people and helping others, and how people can help people who are hurting. We learned a lot.

People told us they enjoyed the workshop and hearing about other people and their stories. One participant summed it up nicely with, "We learn new ideas from each other and we learn about what other communities are doing that they think are working around gambling". There were suggestions about what we could do next, more workshops to help more people learn to talk about gambling in the community. One thing that came through a lot from our feedback was we need more health promotion material – material that means something to us and that can help workers talk about gambling.

As a part of action research and also reflective practice, we visited our session plans, our workshop notes, the evidence. We thought about our experience of this work and other work, and we agreed that the next step was to develop and deliver a remote awareness campaign around regulated and unregulated gambling. Korn and Shaffer in their work of gambling through their public health perspectives suggested that for services and partnerships, we could do a number of things. One of those things was to organise gambling programs across a range of gambling behaviours. For us, this fitted well with what we learned about gambling in some communities around the territory.

We could ensure that the service included a community needs analysis. We see it as vitally important to talk and listen to people about what they want before we can undertake any work. The primary prevention and the model of change for people in communities was at the forefront of our minds and we worked to develop a public awareness campaign. We saw this as a way of offering the least intrusive treatment option first up. These components from the research informed our campaign, which aimed to deliver local gambling health promotion messages and materials throughout a number of remote communities in the territory, and it was suitable to a diverse range of workers, for example teachers, local police and healthcare workers.

The campaign worked collaboratively with iTalk Library to develop a comprehensive public awareness and education program, employing a participatory action framework that told stories about people's experience. We developed messages in a range of languages for the territory and these were distributed through talking posters, local television campaigns, with messages on t-shirts and bags. And from that campaign, we are now working with communities to deliver the painting and talking about gambling workshops. Our aim is always to deliver information and education, and to have people capture their stories and messages in paintings. Paintings have become the local health promotion material and are often displayed around the community, for example in health clinics or at the local shop. People tell us it helps to get people talking about gambling and problems.

So that was back in 2007 and now to this year's work. How do we do it? How do we maintain motivation? How do we maintain momentum with the work that we do? We break the project into small chunks and we break it up throughout the territory. We take time to learn and then to implement that learning action research. We keep the big picture in mind and focus on one piece at a time. It becomes much more manageable. We have a strategy, but we remain flexible and prepared to change throughout the course. We bring in specialists when needed and we try and celebrate the small wins along the way.

So we thought about our process and the evidence and then we thought about change and reorientation. We learned a lot about ourselves and about improvement. We learned a lot about working with a diverse range of people throughout this vast territory. This required a significant amount of resources and internal focus that usually goes to service delivery externally. It took us a while to set up the frameworks, to monitor and review our practice, and to continually improve. Through our service, it has built resilience – resilience in our people, for our communities and in our service delivery.

This here is one example of local health promotion. This painting tells about one project's vision on how to keep communities strong from their perspective around gambling. It talks about keeping culture strong, about education and budgeting as important factors, about attending and keeping informed and connected throughout the community, about our faith and our church, how important it is to keep night patrol strong, to have enough jobs, to have support for new mothers in the community, and to look after older people. This group also identified that a way of keeping strong is to have no involvement with drugs.

Everyone in the group agreed gambling was a problem and it was time to look at how we could work to begin the conversation and assist with community action. The health promotion painting shows individual and community attitudes in regards to gambling and information about strategies for safer gambling. That's all from me here in sunny Darwin where it's 33 degrees and a blue sky, and I'll now hand over to Ashley to talk about strengthening community action.

Gordon

Thank you, Nicola. Yeah, my name is Ashley Gordon. I want to acknowledge the Responsible Gambling Fund here in New South Wales and I want to acknowledge any Aboriginal people online out there tackling those problems in communities, but I also want to acknowledge those non-Aboriginal people helping and striving to improve Aboriginal people's lives, particularly around problem gambling. My work is basically, and the information I'm going to present, is just basically from my work with Southern Cross Uni, but also my work in visiting more than 150 communities across Australia and particularly New South Wales, so hopefully it's some benefit.

But for me, it's about understanding Aboriginal people today, understanding land and spirituality, kinship structures, history and its impact today, and Aboriginal culture as it is today. For me, it's important to understand that Aboriginal people do not have or come from an individualistic world view but instead their selves belonging to and identifying with a collective body and that's why, you know, the approach that I'm talking about today, which is about strengthening community, particularly community action, is about looking at the collective body and everything we do towards that. It should be focused on looking at the issues as a community and as Aboriginal people and culture.

What do Aboriginal people do if they want to address the issues associated with gambling? What we've seen here is many want to deal with it themselves, then secondly seek help from family friends or their mob, then thirdly seek treatment. And I want to talk about this slide because most of the funding in this country goes to seeking treatment, which is very important, but I think we can throw more programs and funding towards providing individuals ways of dealing with it themselves, providing information and knowledge so they can make informed choices. But for us, we are big on family and kinship, so if we can provide skills and knowledge for those people, I think we'll find more family members and friends supporting one another. I just don't think we're doing that as well as we should.

And down the bottom there, many Aboriginal people are generally hesitant about therapy because talking is not seen as an answer to most problems. Now that is slowly improving, but historically many Aboriginal people didn't talk to people to deal with problems, but many – we used to go walkabout and sort our problems out by ourselves, but talking to a 
non-Aboriginal person in particular is very difficult and it's something obviously we're still trying to work with.

Obviously we look at the influencing factors and this is where I talk about understanding the self, understanding someone's self-esteem and confidence and values, and what's going on in their lives, but also looking at the influencing factors of family, particularly around the kinship structure, my responsibilities in that family, the influences that come from family that are impacting me. Then we need to look at community, because I think community, there are a lot of responsibilities. There's a lot of different families and different relationships, but there's a lot of expectations that again can influence ourselves to either be tackling or confronting problems, particularly around problem gambling. And obviously the influencing factors from culture, that is very important, and then you throw in Western society and what factors from Western society could be impacting me to gamble. But again, you've got to look at all the four circles there, but also the Western society.

I talk about walking in two worlds, understanding Aboriginal people need to understand ourselves, our community, our family, our culture, and that's evident when we look at trying to counsel someone. But then you look at the non-Aboriginal world and you look at the influencing factors there from gambling and drugs and alcohol, to work, family relationships, education. But when I'm counselling Aboriginal people, I talk about how big is the Aboriginal people. Is that circle there on the left bigger or is it smaller than the non-Aboriginal circle? And again, we look at that and try and improve the way people are looking at themselves and their approaches, and what they currently value. We can look to help that individual but also from a community perspective, we can also look at what influencing factors are obviously there for community as well.

Why are we not addressing our gambling in many Aboriginal communities? I just put down some points. There's many other factors, but, for me, there are so many other issues that Aboriginal people and governments are facing that need attention and they're all there for you to read. But obviously you know that drugs is now – particularly ice – is a huge problem but you look at our physical health, our cultural identity. Many things that we're out there addressing, and gambling is still a very sensitive issue to bring up. In many communities, it's still very much hidden. Even though you talk to many people, they know it's causing problems, they know of many people struggling with problem gambling. But again, it seems to be really sensitive and still very hard for us to bring to the surface.

There's a lack of strategies to address the issues associated with problem gambling. At the moment, most states are looking at the majority of their funding going towards gambling counselling. For me, you know, we could look at other ways. You know, we've talked about a couple of them already. I know Amity is doing a great job doing other things as well around education and awareness, even tapping into healing programs and Aboriginal specific services, but again we need to look at other ways to address problem gambling especially in Aboriginal communities.

Gambling is seen as an individual problem, not a community concern, and that's where if we can bring it to the attention of the community and make it as a priority – and that's why it relates to the bottom slide there. Aboriginal people and communities are not yet recognising that gambling is a problem. If it's not discussed or acknowledged, it doesn't become a priority to address. So if we want to implement programs, we need to ensure that the community is discussing it, is talking about it, can recognise that we need to move forward and address these problems. If we acknowledge it, we give ownership to the Aboriginal community and then it can become a priority to address.

When we talk about service delivery to problem gambling services, it's about working together with our community – especially Aboriginal services, working closer with them. I know many gambling help services struggle there. We need to find local Aboriginal leaders and supporters of what we're all trying to do. I know here in New South Wales, I call them safe gambling Aboriginal ambassadors, and they're out there helping me. Even though they might be working in other industries, particularly health, they are still focusing on problem gambling and they're assisting me in their own community.

Effective education awareness programs – we spoke about that, but our people are very visualised people; we want to see things out there particularly down the bottom there with marking material. It's very important to us. It's very visual. Governments allowing flexible service delivery for gambling help services. I know that many allow us to report on relationships building, and building that rapport with community. All the issues and barriers that goes with trying to work with an Aboriginal community takes time. We need patience, we need understanding. A lot of services tell me that, you know, they can't report on anything outside of client numbers and face to face. I know a lot of work that they do is quite valuable, but they can't report on that. It's all back to relationships building and cultural sensitivity.

Even back to inviting premises and the location of the service needs to be looked at. There are some services out there that communities just don't want to go to, and that comes back to the image of that organisation. I think that more work needs to be done on the image of many gambling help services and how it's perceived in Aboriginal communities, and even educating community on what they do. What is counselling? You know, is it group therapy? Is it like GA? Do I have to worry about the cost or anything? Can I bring my family? Can I bring my mob with me? There are a lot of answers that community need to have.

As counsellors, we need to show community and people our values, our character. We're looking at the respect, the trust and the honesty. Our mob really want to see your fair dinkum approach. We want to see that it's genuine. We talk about being holistic. It cannot just focus on the gambling because we know how closely it's linked with many other issues and problems in our life, and there's so many other help services out there that we could be tackling rather than relying totally on gambling help services.

So, realising that you need to be prepared to build relationships and they need to be genuine relationships, not tokenistic. We'll need to change and adapt and be flexible. There's a lot of flexibility when working with Aboriginal people in community and that needs to occur. Listen, learn, share. Just because people are there to help doesn't mean Aboriginal people want it. It's about sitting down and listening, and being able to share. Go to the communities, being visible, you know, being able to implement a variety of therapies. I know there are a lot of services around Australia. It's pretty much one therapy or maybe two, but again looking at a variety of therapeutic practice that might be effective for Aboriginal people. We've seen a lot of people doing more art therapy and more narrative therapy. More Aboriginal healing services and programs are being adopted now.

And then finally my last slide is about strengthening community action and empowering community. So in summary, basically if services can implement awareness raising programs, a quality education service, quality engagement in the communities, allowing that collaboration, the planning that needs to go into it before you even get to a community needs to take place so we can implement quality services including cultural appreciation. If we can do that well, community then acknowledges that gambling may be a concern. They begin to recognise that they need to take action, recognise that it is causing problems for families. They then can take ownership of the problem associated with problem gambling and that's really important.

Because if we can give ownership to a community rather than tell them what they should be doing and telling them how things should go, you'll find that a community will take more action and a lot quicker. But we need to give ownership to the community so then they can be engaged and they're a part of the process allowing for collaboration. Then community can sit down and help plan what they would like to see happen in the community. It's not about anyone telling them but they're a part of the planning process, which means they will take action. And then you will have a number of supporters, a number of people in community helping services and the community to move forward. For me, that's how we build stronger communities and empower communities. Thank you, I'll hand back to you now, Marisa.

Fogarty 

Thanks, Ashley. Again we would like to say thank you very much to everyone for taking the time to listen to us today. We really see this as a very important issue that needs significant investment. That is, investment in resources, investment in research, investment in policy and program development in Australia. The potential benefit of adopting a health promotion framework is significant in terms of empowering Indigenous people and communities around Australia to address gambling issues. If you have further questions, please don't hesitate to contact us.

END OF TRANSCRIPT

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Slide outline

  1. Addressing gambling in Indigenous communities: Embracing community, diversity and wellbeing
    • Australian National University
    • Child Family Community Australia, Australian Institute of Family Studies
    • Australian Gambling Research Centre, Australian Institute of Family Studies
    • For further information please contact: [email protected]
    • Fogarty, M., Coalter, N., Gordon, A. & Breen, H. (2015). Addressing gambling in Indigenous communities: Embracing community, diversity and wellbeing. Tuesday 29 September. Australian Gambling Research Centre, Australian Institute of Family Studies, Melbourne.
    • The views expressed in this presentation are those of the presenters, and may not reflect those of the Australian Institute of Family Studies or the Australian Government.
  2. Acknowledgement
    • We would like to acknowledge the traditional custodians of this land and pay respect to Elders past and present.
  3. Authors:
    • Dr Marisa Fogarty – The Australian National University, ACT
    • Ms Nicola Coalter – Amity Community Services, NT
    • Mr Ashley Gordon – Warruwi Gambling Help Service, NSW
    • Dr Helen Breen – Southern Cross University, NSW
  4. Introduction
    • Gambling is an activity that impacts on Indigenous families and communities around Australia in diverse and complex ways.
    • There is a significant lack of coordinated research, service delivery and policy focus in this area around Australia.
    • Highlight:
      • The diversity of Indigenous people’s gambling practices
      • The diversity of contexts in which Indigenous people live around Australia
  5. Indigenous Gambling Research
    • Australian Aboriginal and Torres Strait Islander Health Survey 2012-13: Found 8% of Indigenous people reported gambling as a family stressor.
    • Longitudinal Study of Indigenous Children (2012) Wave 3 reported 26% of primary carer respondents reported that either they or a close family member had a gambling problem. LSIC also found that irrespective of remoteness, Indigenous people were unlikely to engage with gambling help services.
    • Other research suggests that Aboriginal people experience problems at two to five times the rate of the general population across all states and territories (Stevens and Young 2009).
    • National Aboriginal and Torres Strait Islander Social Survey 2002: Findings reported in Stevens & Young (2010) Independent Correlates of Reported Gambling Problems Amongst Indigenous Australians, Social Indicators Research, Vol 98, Iss 1, pp 147-166.
  6. Health Promotion Framework:
    • A landmark commitment in 1986 by the World Health Organization produced the Ottawa Charter for Health Promotion (WHO 1986).
    • The five principles for action of the Ottawa Charter are:
      • Build Healthy Public Policy Create supportive environments
      • Strengthen community action
      • Help people develop skills
      • Re-orientate health services
      • WHO Health Promotion logo
  7. BUILDING HEALTHY PUBLIC POLICY
    • WEBINAR, AUSTRALIAN GAMBLING RESEARCH CENTRE, AUSTRALIAN INSTITUTE OF FAMILY STUDIES. SEPTEMBER 29, 2015
      • Presenter: Dr Marisa Fogarty
      • Author: Dr Helen Breen
      • Co-authors: Professor Nerilee Hing, Ashley Gordon, Associate Professor Jeremy Buultjens, Dr Alex Russell, Centre for Gambling Education and Research, Southern Cross University
      • Acknowledgements: cooperation of Aboriginal participants
      • Funding: Australian Research Council & Australian Postgraduate Awards
  8. Central tenet of building healthy public policy: people’s health & wellbeing
    • Health, underpinning foundation for public policy development,
    • Identifying impacts, risks & barriers,
    • Resource allocation.
  9. Why building healthy public policy is important for Aboriginal people with gambling issues.
    • One size does not fit all,
    • Implications of the impact of high intensity gambling,
    • Limited research to support building healthy public policy.
  10. Risks associated with gambling by Aboriginal people
    • Risk & risk factors,
    • Who faces gambling risks?
    • High risk gambling behaviour,
    • Risk factors associated with gambling.
  11. Identifying protective aspects of gambling by Aboriginal people
    • Protection & protective factors associated with gambling,
    • Cultural factors & their importance,
    • Individual and social group controls
  12. Conclusion
    • Family networks, cultural values and social relationships appear to have enduring power in helping to spread awareness, managing to assist in preventing various harms while protecting some gamblers from gambling risks.
    • This is an important, appropriate and valuable resource to harness, to contribute to building and resourcing healthy public policy for Aboriginal people who gamble.
  13. Developing personal skills Creating supportive environments
    • Author: Dr Marisa Fogarty
    • Acknowledge the support of: ANU Centre for Social Research and Methods ANU Centre for Gambling Research
  14. Developing personal skills
    • Defining health:
      • Health is not just the physical well-being of the individual, but the social, emotional, and cultural wellbeing of the whole community. This is a whole-of-life view and it also includes the cyclical concept of life–death–life (NAHS Working Party 1989:x).
      • NACCHO, National Aboriginal Community Controlled Health Organisation
  15. Holistic development of skills
    • Flowchart:
    • Holistic development of skills
    • Incorporation of Indigenous knowledge and understandings
      • Strengths based approach
      • Identifying different skill sets
    • Individual
    • Family
    • Community
  16. A strengths approach to develop skills
    • Shift overall focus away from the ‘deficit’ or the ‘problem’ or ‘pathology’ of an individual in relation to gambling
    • Recognition:
      • Every individual, family, group and community has strengths, and the focus is on these strengths rather than pathology
      • The community is a rich source of resources  
      • Interventions are based on self-determination  
      • Collaboration is central and essential, and
      • A belief that all people have the inherent capacity to learn, grow and change.
  17. Indigenous understandings of gambling
    • The ethical underpinning of the application of a health promotion framework.
    • Ethnographic fieldwork conducted in the Northern Territory
      • Different ways and different forms of gambling
      • Understandings of gambling can be different
      • Understandings and use of money can be different
    • Fogarty, M 2013, From card games to poker machines: Gambling in remote Aboriginal communities in the Northern Territory, PhD Thesis, Charles Darwin University, Darwin. http://espace.cdu.edu.au/view/cdu:40111
  18. What does developing skills look like?
    • Education and awareness
      • In particular, developing resources for community health and education services, community organisations and institutions to educate and develop skills in understanding and addressing gambling issues.
    • Developing guidelines for ‘best practice’ in service delivery to address gambling and the impacts on Indigenous families and communities in culturally appropriate ways.
    • Developing resources within communities, for communities, to address gambling issues (i.e. community guidelines for ‘safe’ gambling)
    • Having a multi-level, multi-service approach working simultaneously at individual, family, community levels.
  19. Create supportive environments
    • Creating safe, supportive, appropriate gambling help services – this looks very different in different states around Australia (what constitutes ‘best practice’ in Australia?)
    • Cultural competency of services
  20. Multiple domains within an environment
    • Looking at a community, town, or city as a ‘whole’ environment with multiple resources available to address gambling (for example, the schools, health clinics, early childhood centres, women's centres, police services, child protection services, councils, local business).
    • A significant amount of expertise and resources already exist – so its about engaging and educating those people outside of gambling services in the broader ‘community environment’.
    • Counselling services, gambling help-lines, financial counselling, parenting programs, youth diversionary programs, school programs, community councils and boards, family, presented to people as an accessible package – creates supportive environments
    • Then, self-sustaining supportive environments addressing gambling issues are born.
  21. Reorientation of health services
    • Amity community services
  22. Where we work
    • Amity building
    • Four wheel drive trucks on bush track
    • Coastal scene
  23. Action research
    • Planning
      • identifying
      • informing
      • organising
    • Acting
      • trialling
      • collecting
      • questioning
    • Observing
      • analysing
      • reporting
      • sharing
    • Reflecting
      • evaluating
      • implementing
      • revisiting
  24. Kolb's Reflective Teaching
    • Experience
      • actions past/present
    • Observation
      • documenting what happened
    • Reflection
      • making sense, investigating, theorising
    • Planning
      • making plans in order to take further action
    • Loop around to Experience
  25. Motivation
  26. Reorient services
    • This may mean change for services, change for workers and changes for people.
    • Change is a process.
  27. Aboriginal artwork
  28. Strengthen community action
    • Presentation by Ashley Gordon
    • Warruwi gambling help
    • NSW Aboriginal safe gambling services
  29. Understanding Aboriginal People Today
    • Land and Spirituality
    • Kinship Structures
    • History and its impacts on people today
    • Aboriginal culture of Today
    • It is important to understand that Aboriginal people do not have or come from a an individualistic world view but instead see ourselves belonging too and identifying with a collective body
  30. What do Aboriginal people do if they want to address the problem?
    • Deal with it themselves
    • Seek help from family, friend or cousin
    • Seek treatment
    • Many Aboriginal people are generally hesitant about therapy because talking is not seen as an answer to most problems
  31. Influencing Factors
    • Diagram: Community, Family and Culture are all a part of the Self and are affected by Western Society
  32. Walking in Two Worlds
    • Aboriginal
      • Culture and identity
        • Community, Self, Family, Culture
    • Non-Aboriginal
      • Western World
        • Relationships, Gambling, Education, Work, Alcohol and drugs, Family
  33. Why are we NOT addressing gambling in Aboriginal communities
    • There are others issues that Aboriginal people and governments are facing and need attention- i.e. alcohol, drugs, homelessness or home ownership, physical health, mental health, cultural identity, grief and loss etc.
    • Lack of strategies to address the issue
    • Gambling is seen as an individual problem NOT a community issue
    • Aboriginal people and communities are NOT yet recognising that gambling is a problem, if its not discussed or acknowledged it does not become a priority to address
  34. Effective Gambling Help Services
    • Work together with communities and local services, especially those that are Aboriginal.
    • Find local people, Aboriginal leaders, even other service providers to help
    • Effective education and awareness programs
    • Governments allowing flexible service delivery for gambling help services Inviting premises and location
    • Quality marketing material and image promotion
  35. As Counsellors
    • Values – Respect, trust, honesty, “authentic approach”
    • Holistic program, cannot just focus on gambling!
    • Be prepared to build relationships
    • Willingness to change, adapt and to be flexible
    • Listen and Learn - share
    • Go to the community – be visible
    • The ability to implement a variety of therapies that would be most effective for Aboriginal people
  36. Strengthening community action and empowering communities – How?
    • Services
      • Awareness
      • Education
      • Engagement
      • Collaboration
      • Planning
      • Implementation
      • Cultural Appreciation
    • Community
      • Acknowledgment
      • Recognition
      • Ownership
      • Engagement
      • Collaboration
      • Planning
      • Action
    • Stronger communities
    • Empowered communities
    • Gambling help

Questions?

  1. Join the Conversation
    • Continue the conversation started here today, ask further questions and access related resources via the following link: www.aifs.gov.au/cfca/news-discussion

Presenters

Dr Marisa Fogarty is a Postdoctoral Fellow at the ANU Centre for Social Research and Methods. Marisa has a PhD in Anthropology from Charles Darwin University and a Masters in Applied Anthropology and Participatory Development from the Australian National University. Marisa has extensive experience researching gambling and working with Aboriginal people and communities around Australia.

Nicola Coalter is a registered psychologist currently undertaking a Masters in Public Health. Nicola works as the coordinator of Amity’s Territory-wide gambling project, which encompasses coordination of a diverse array of treatment services, community education and prevention strategies and projects, health promotion, training and partnerships and consultation activities with a range of stakeholders.

Ashley Gordon is an Aboriginal Australian from the western-NSW community of Brewarrina, a descendent of the Gamilaroi people. Ashley has been a gambling counsellor for 7 years and is now a fulltime Aboriginal Gambling Consultant. Ashley is also a researcher with Southern Cross University. He has been appointed to the Federal Ministerial Expert Advisory Group on Gambling and is a Board Member of the Australian Gambling Research Centre.

Dr Helen Breen is an adjunct research fellow with the Centre for Gambling Education and Research at Southern Cross University. Her longstanding research interest in gambling has included investigations with many specific population groups including older people, women, tourists, club members, counsellors and Aboriginal people. Her research has been firmly based on public health principles, with an overall view to improving the context of people’s lives.

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