Online and digital approaches to support wellbeing in Aboriginal and Torres Strait Islander children and families
26 April 2023, 1:00 pm to 2:00 pm (AEST)
Trish Ratajczak, David Edwards, Jaylene Friel, Dana Shen
About this webinar
Aboriginal and Torres Strait Islander people often experience barriers to seeking help. These include a lack of culturally appropriate services and geographical remoteness.
Online and digital approaches that are community-led can address some of these barriers and support the resilience of Aboriginal and Torres Strait Islander families.
This webinar will feature three Aboriginal presenters that will share their expertise in innovative, Aboriginal-led, online and/or digital programs including: Baby Coming You Ready?, WellMob First Nations , SMS4DeadlyDads and the Stay Strong AIMhi for Youth App.
This webinar discussed:
- How Aboriginal-led online and digital programs can help address barriers to accessing health services.
- Examples of culturally safe, online and digital approaches to supporting children and families.
- Practice tips and insights for using online and digital approaches to remote service delivery for Aboriginal and Torres Strait Islander children and families.
This webinar is recommended for practitioners and service providers who provide support to Aboriginal and Torres Strait Islander children and families.
This webinar was co-produced by CFCA and Emerging Minds as part of a series focusing on child mental health. CFCA and Emerging Minds are working together as part of the Emerging Minds: National Workforce Centre for Child Mental Health, which is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.
Audio transcript (edited)
DANA SHEN: Welcome to today’s webinar, Online and Digital Approaches to Supporting Wellbeing in Aboriginal and Torres Strait Islander Children and Families. My name is Dana Shen. I’m a Ngarrindjeri Chinese woman based in South Australia, and I’ll be your facilitator for today. Before we get started, just a few things that I’d like to start with. First of all, I wanted to acknowledge the Country and the traditional custodians of all the lands that we’re meeting on today. I want to pay my respects to elders past and present, and emerging leaders, and also recognise the cultural authority in the room, of all my First Nations friends, kin, brothers and sisters as well. And welcome to all our allies who are with us as well.
A bit of housekeeping before I get on and introduce briefly the panellists. First of all, the webinar is recorded and will go on the AIFS website in about two weeks, so you’ll be able to access it again there. As we go, feel free to put questions down in the questions box. We’ll do our best to respond to those questions, but if we can’t live, we’re doing a recording afterwards and we’ll try to address the questions that we can as well. There’s a handout, you can see a series of handouts on your screen, on your bottom righthand corner. There’s a range of different services that we’ll be talking through today and there’s more information about these programs that are available there if you wanted to learn more about each of those.
Now, most of you know that we’re touching on a range of topics today which could include stolen generation, child removal, family violence, suicide and self-harm. So, I just want you to feel comfortable to leave at any time, feel that you need to for your own wellbeing. We also want to say that obviously this is a really, really big topic that we’re touching on today, and we could talk so much longer than an hour that we’ve got, but we’ll do the best we can to cover as much as we can, and of course there is the handouts. Finally, I’ll remind you at the end too, there’s a short survey available after the webinar today, we’d appreciate any feedback you might have and please fill in that survey at the end of our panellists talking with me today.
So, the panel that we have today are the wonderful Trish Ratajczak, David Edwards and Jaylene Friel. Now, before I start chatting with them, and they can talk a little bit more about themselves and where they come from and their work and the tools involved, we decided that we’d like to play you a five minute animation from Baby Coming You Ready? website. It’s also on the Wellmob website. It’s called Journey of Wellbeing. It takes about five minutes and it is an animation, and it’s really introducing you to this topic around social and emotional wellbeing and also, the impact of colonisation. Just a reminder, there could be a little lag in this video and audio. If you could just give it a moment as it begins to play.
Okay, so I want to move now to talk to our panellists today and in the first instance, I’m going to be asking each of them to introduce themselves and talk a little bit more about the tools that they’re involved with. So, I will start with David. David, could you talk a little bit about yourself. What brought you to this work? And then we’ll come to the tools.
DAVID EDWARDS: Thank you. I’m David Edwards. Wiyabu. I’m a Worimi person. My grandmother’s people were from Karuah north of Newcastle, and I grew up in Meanjin and Brisbane, and now Zooming in from Widjabul Wia-bal country in Lismore, Northern New South Wales. I previously worked in the environmental and health sciences, and only recently got into I guess indigenous health promotion and education. I’m not a clinician. I guess I put myself as an educator in terms of pigeonholing my role. I have got two main roles, one with the Wellmob website which is the online library of First Nation specific social emotional wellbeing resources, like apps and videos and podcasts and websites, as well as work on a small indigenous team as part of the SMS for Dads project, which we recently relaunched a First Nation specific version called the SMS for Deadly Dads, and for those non-indigenous allies out there Deadly is our term for awesome, great. So, we’re trying to have a health promotion text based service that meets the needs of our soon to be and new dads. So, it’s really for the perinatal period.
I also do a small role with the Core of Life Youth Education Program around pregnancy and childbirth. I got into this work just because I’m passionate about health and wellbeing and I like to see myself as an advocate for our diverse and wide communities across this broad country. Thanks.
DANA SHEN: Thanks so much, David. You’ve talked a little bit about the tools, but I think it’d be great just to get a very, very quick summary of each. What do they do and who are they for? What’s the kind of thing that they’re trying to do with the different communities that they’re targeted at?
DAVID EDWARDS: Sure. Well, the Wellmob website was co-designed for frontline health workers and community workers that work with our mob. But it’s also very much been designed with our end users in mind, our communities. So, basically it’s just a portal or an online library of First Nation specific social emotional wellbeing tools, and I mentioned before about apps and websites. We just tried to make it easy for workforce and our communities to go to one spot to find anything to do with wellbeing and health that has been assessed against criteria to make sure it’s credible, less triggering, that’s evidence based where possible, and take that barrier away from our time poor practitioners and make it easy for them to find these sorts of tools to work with our mob.
The SMS for Deadly Dads is really just an information service that’s text based, so if you’re a soon to be dad, so your partner’s just past the first trimester of pregnancy, right through to when bub’s six months old, the messages actually continue up to when bub’s one year of age, but it’s really just information and tips for new dads to help them on the parenting journey, and I can explain a little bit more about that later.
DANA SHEN: Fantastic. Great, thank you so much, Dave. Jaylene, so can you tell us a little bit about yourself, what brought you to this work?
JAYLENE FRIEL: Well, my name is Jaylene Friel. I work at Menzies School of Health Research in the Stay Strong Team, which is the wellbeing team. I started this work, well I started working here straight after school, Stars Foundation which is in the schools that look after the Aboriginal and Torres Strait Islander young people at the schools, helped me, well I’ve always had a passion for helping my people, that’s kind of an obligation being a young Aboriginal person, there’s recognising the struggle we go through and wanting to overcome it and be better and have a quality within my race.
I think the people at my school saw that I had a passion and the people at my workplace obviously saw that I had a passion and have me the opportunity to excel, and now I’m the youth project officer. I finished my traineeship that I did back in 2021, so I finished that up and now I’m the youth project officer here. I just help them with their research and helping young Aboriginal people find access to help and have a better mental health literacy and get our quality that we deserve.
DANA SHEN: Fantastic, Jaylene. You’ve started to do this already, but it’d be great if you could very briefly talk about the tool that you’re working with and who is it for and what does it do?
JAYLENE FRIEL: So, at the moment we have three apps around mental health. One is Weathering Well, that’s for farmers. The two Stay Strong for adults and AIMhi, which is kind of a spin off I would say of the Stay Strong app for young people.
DANA SHEN: Fantastic. What do they do for people? What’s the main purpose of them?
JAYLENE FRIEL: So, the main purpose is kind of helping bridge that gap of accessing help and kind of giving them tools, giving young people, and adults, Aboriginal people tools to manage their mental health while awaiting for professional help. Just re-sparking those strengths that we know we’ve always had.
DANA SHEN: As I understand it, Jaylene, it also means that professionals can use these tools with Aboriginal people, can’t they? So, it can be a shared thing. Got that right?
JAYLENE FRIEL: Yeah. So, the Stay Strong app was designed for clinician supported app, yeah, it’s a clinician supported app, to go through it with a clinician. Yeah.
DANA SHEN: Fantastic. Thank you, Jaylene. Trish, could you tell us a little bit about yourself and what brings you to this work?
TRISH RATAJCZAK: Hi, everyone. I’m Trish. I’m a Palawa woman. So, my grandma’s country is northeast of Tasmania, and my grandfather’s country is on the top part of Tasmania in Burgess Cove. I am a clinician, so I’m a clinical midwife. I have also worked in academic space as a lecturer in Aboriginal health and wellbeing for upcoming health professionals. So, I came into this space because I kind of got poached, to be honest, and asked if I’d be a part of Baby Coming You Ready? So, I have been part of it from the beginning, over the 10 years, and now I work fulltime in the research space.
DANA SHEN: Fantastic. Thanks, Trish. Yeah, again, it’d be great – Baby Coming You Ready? What is its primary purpose and who is it for?
TRISH RATAJCZAK: So, Baby Coming You Ready? is a digital innovation is to help Aboriginal mothers in their social emotional wellbeing. So, it replaces things like alcohol screening, family domestic violence, all those kind of generic things that you may see in a health space that is done in a westernised way. So, Baby Coming You Ready? has been developed from community with a lot of engagement through elders, health clinician, Aboriginal health clinicians over 10 years, and has all been based on – they just want a better way of doing it our way really, about how to screen for our wellbeing.
So, it’s a digitised rubric meaning it has voiceovers that guide gentle yarn between the clinician and the mother, and it also has strength based images throughout the rubric that a mother can self-select, and it helps her have a yarn and a journey through her emotional wellbeing that is our way of doing things.
DANA SHEN: Trish, it’d be great – I know that people that are listening today will be really interested when you’ve talked about our way of doing and being. I wondered if you could kind of elaborate a little bit more on the ways in which this tool is working for us.
TRISH RATAJCZAK: Perfect, yeah. So, there is a big power in equity in health care between a clinician and a mother. So, we want to break down those barriers, and this is one way of doing it with Baby Coming You Ready? So, the woman has the control of using the rubric. She is the one that is selecting what is relevant for her, rather than having the clinician have their own thoughts and says on what they think is maybe a concern or a worry for that mum. But also, Baby Coming You Ready? wants to promote change, improve outcomes. So, it’s really strengths based and is a preference to rather than doing the Edenborough Postnatal Depression score that is a common practice that is used for emotional wellbeing screening.
So, that’s really what we call a wadjela way, which is a white way of doing business and in our communities this is not appropriate. You need to have a background about who grew you up, who did you look up to, what are your strengths, what makes you feel deadly and strong. These such things is being at home on country, our ancestors, our connections to our family are all important factors.
DANA SHEN: Fantastic. Would it be fair to say, Trish, that what it also does is kind of provide a holistic notion of what it means to be a human being it sounds like, from what you’re actually talking about?
TRISH RATAJCZAK: Yeah, correct. So, it’s holistic. It’s not just looking at the individual person, it’s about looking at our family, it’s our connections to our country, and also we have a different viewpoint of health. So, this is the gentle way off doing it with clinicians and actually helps build that barrier between a clinician and an Aboriginal woman, building a therapeutic trust that will hopefully engage with the mother wanting to return to their service that is culturally safe and appropriate. But the main thing that we want to make sure that everyone knows is that Baby Coming You Ready? has actually come from the community’s wants and needs, so this is vital for women to feel that and know that, and that actually has been fed back that they love this.
DANA SHEN: Fantastic. We’ll be talking a little bit more and going to a bit more depth about that. What does this mean to actually have resources that developed? But we’ll come back to that. Dave, I wondered if you could talk a little bit about in terms of the tools that you’re working with, what are the sorts of things that they’re trying to really do in terms of getting rid of barriers, improving access for our people and for the community? I just wondered if you could touch on a bit more of that.
DAVID EDWARDS: Yeah, sure. Well, the Wellmob website being a repository of credible resources in that social emotional wellbeing space for First Nations people, just makes it easier for workforce to be able to put their finger quickly on something that they might use in a consult. For example, Jaylene talked about the Stay Strong app which is a strength based counselling tool. So, you can find that on Wellmob if you use the topic searches. We’ve got six main topics, mind, body, healing, keeping safe, our mob, culture. You also use the search bar and put in their goal setting tool, or if you knew the name Stay Strong you put it in there. Basically, it will give you a quick link through to the resource. We haven’t developed any of the resources we’ve just put them in the one place.
So, it overcomes that barrier of accessibility and as I mentioned before, our workforce is stretched, and I think during the COVID-19 pandemic we all learned to use online tools a lot more and became more comfortable. I think it’s really just a matter of our clinicians and practitioners getting more confidence and understanding what’s available there, and Wellmob’s a great way to have a look at the plethora of online materials that may be able to be used both in session as well as for clients to take them home and use them out of session and use them as part of their self-care practice.
With the SMS for Dads, or SMS for Deadly Dads text based information service, we all know through both anecdotal and scientific evidence that our first time and new dads don’t often engage with mainstream antenatal classes or midwifery visits. So, we’re trying to provide first time and new dads with some really easy to understand and safe and accessible tips and tricks about becoming a dad, and all the messages that are tied to the age and stage of the baby. So, when a new dad enrols, even if it’s during his partner’s pregnancy, he can put in the expected date of delivery or if it’s after birth, the date of birth, and the messages are timed to what stage the pregnancy should be at, what things might be happening when bub’s born the messaging that’s tied to the different developmental stages of bub.
The three main information objectives of the text messages are around supporting the pattern, co-parenting and team parenting, around bonding and engagement with bub both in utero and after birth, and thirdly but really importantly, for self-care for dads. So, hopefully the messages are just an easy point for dads to get some credible information. They get three text messages a week and they can just bank them up on their phone and when they get a spare moment they can have a look and look at some of the links that we also include.
DANA SHEN: Fantastic. I think it’d be great too, Dave, and I’ll come back to you on this, is to really talk a bit more about providing that space for dads to be involved in the journey and how can we support that. So, I’ll come back to you on that. Jaylene, it’d be great to have a chat with you now, as a young leader yourself and doing work with young people, it’d be great to understand what is it about this tool that’s assisting with access, is supporting the voice of young people? Just really interested in your perspectives on the work that you’re doing.
JAYLENE FRIEL: I guess it’s the resource, that the app is like a tool, like a tool in a clinician’s back pocket or not even just the clinician, the young person themselves, just having availability to these resources and having the strength, reminding the strength, it’s a good understanding of the two way of having both perspectives. That’s the only way that can really overcome these issues, is having both perspectives. You can’t just have one perspective or something. This tool caters for both perspectives. It has the clinical science stuff behind it, psychology behind it. I’m not too sure about it myself, but what I do know is the cultural aspect of it and the being and of knowing just how Aboriginal people are, just how we think our perspective being appreciated and respected in a tool that not only helps the young person than the race itself, but the clinicians that want to help us get better but like who can assist us.
Because like the video said at the start, we don’t want to be fixed, we want to be walked alongside and understood and respected. So, yeah, I think it’s a very good interpretation of two-way learning and two-way understanding and overcoming barriers really of stigma, and all those intergenerational things that we carry, the stigma of mental health, addressing our mental health. Because we are strength based, so even just taking accountability of those no good emotions and those things that come from systematic oppression and just external factors, helps us and it’s a good understanding for us. Not only just young people, but the adults as well.
DANA SHEN: Fantastic. I think for me what I really appreciate about what you’re saying is that this kind of tool helps with a power dynamic too, doesn’t it? Because it’s actually providing, making an equal space for both voices, and acknowledging value, the worth of the different philosophies in that. I really appreciate the way you spoke about that, Jaylene, I think that’s a really important point for listeners to pick up on, is the message that Jaylene’s just given.
So, I want to come back to the issue about how these are designed, and I know Trish, you touched on it, and it’d be great to hear a little bit more about what is the work of co-design with our people? How do you make something actually with our own communities, and do that in a really effective way? I know participants will be interested in that. So, Trish, I wondered if you could, from your perspective and experiences, talk a little bit about that.
TRISH RATAJCZAK: Sure. So, developing resources or support for Aboriginal communities is not a quick process, meaning that with that regards to Baby Coming You Ready? has taking over 10 years, but we’ve had about 150 Aboriginal and non-Aboriginal allies walk alongside us and help develop Baby Coming You Ready? But the most important thing that has really driven Baby Coming You Ready? is the elders Noongar Boodjar where we are at the moment, they’re the ones that have driven it and have actually asked for these to be developed. So, that means working with community, working with different sectors, government and also non-government Aboriginal health services. But what is most important in these spaces, Aboriginal voices are the voices in this space. So, that means not just one Aboriginal language group, but many language groups. Also, not just our grandmothers, our aunties, there’s also young women and men. These are all important voices and have all contributed to Baby Coming You Ready? development.
So, we don’t own it. We’re just happy to be privileged to be able to support and access what community wants and has requested. So, one of those things that has community shared with us is that they wanted to know more about parenting, and that is also not just for the mums, but for the men as well. So, through Baby Coming You Ready? on our website, you will see there is some parenting resources there. They have been asked from our community, that they don’t have full awareness of these processes and wanted to have more information. So, that’s just one little snippet. But it all goes down to community design, so their artwork in Baby Coming You Ready? is done by Aboriginal artists, Aboriginal aunties and elders voiceovers in the Baby Coming You Ready? all designed by Aboriginal community.
DANA SHEN: Fantastic. Yeah, we’ll be talking a little bit more about the elements of that in a moment, so Trish has touched on that but I’ll be bringing that out with all of the panellists in a moment. Dave, in your perspective and in the experience of the projects that you’re involved in, how did the co-design community led approach work in this particular instance?
DAVID EDWARDS: I guess you made sure it was grassroots from the bottom up. With the SMS for Deadly Dads we had our Aboriginal lead, Uncle Mick Adams, get together a group of Aboriginal male health workers from across the country and they formed a First Nations advisory group that guided us on the development of the message set, as well as just the general governance for the project. So, I think it’s really important to have frontline workers involved in developing projects or resources for themselves. Similar with Wellmob we had reference groups in Kaurna country in Adelaide and Larrakia country in Darwin and here in Bundjalung country in Lismore, guide us on the development of that to make sure it did meet their needs, and also to make sure that our end users, our communities were going to find it culturally responsive and inviting.
In terms of family and child resources, like we’ve got lots of resources there that can be used to unpack issues that a clinician could sit down with a child of an adolescent or a family member and talk through something that’s going on. The italk studios have some great videos around a range of I guess wellbeing issues that are really good secondary or third party resources that can take away the stigma and shame that Jaylene talked about, and make it easier for a practitioner to talk about a difficult topic. Menzies also have another great video around alcohol use, which is called Grog Brain, which is a great educative video that can explain the impacts of alcohol on the brain.
I think it’s more and more about getting resources that have been co-developed and co-designed with community because we have got our unique ways of being and doing, and it’s really important that we avoid the black wallpapering as we can sometimes call it, of mainstream resources just being made to look like they’re First Nation specific by a bit of artwork. We’re really trying to tap into our deadly indigenous health workforce out there as well as our communities and our non-indigenous allies to help us make sure whatever product or materials that we produce all meet their needs.
DANA SHEN: Dave, I just wanted to draw out a couple of things that you said, because I think that this is really important. I think the first thing, one of the big points that I heard was how do you genuinely design it with directly with Aboriginal people where it is you’re really building it with people, you’re not trying to have it as a second of add on option. So, I think that was a really important point that you made. The other thing I also wanted to touch on, and I’ll go around the whole panel and ask you about this, you talked about the words culturally responsive, and I know also cultural safety is important. I wondered if we could just explore amongst all of you a little bit about what that means for you and what you think the tool is doing to do that. So, Dave, I wondered if you could start, what does it mean to be culturally responsive, culturally safe? What are those key elements from your perspective?
DAVID EDWARDS: I think it’s a really interesting question and probably a complex topic to answer in this webinar. But from a nutshell perspective, I think it’s about ensuring that the language is simple and plain, and that maybe brings in some of our cultural nuances. Like, with the SMS for Deadly Dads we’ve done some short videos so that Uncle Mick Adams as an elder, talks to new dads about some common issues that they might come across, like sex during pregnancy as well as bonding and attachment with bub, or co-parenting and some of the struggles around getting balance between hanging out with the fellas and playing sport versus being home for family time. So, some really simple, plain messages that are video based which a lot of our young people really gravitate to. Also, great resources for a practitioner to use in session to talk about certain topics.
So, I think cultural responsive probably means different things to different people, but I think having simple but culturally embedded messages, like a lot of our content in the SMS for Deadly Dads is generally like it’s actually the message is coming from baby, whether that’s in utero or post-birth, but we’ve got some little cultural lingo put in there to make it feel like it’s coming from a First Nations person. With the Wellmob website we try to use terms like mob and grog and some other terms that are colloquial and we all connect with across the country no matter what your language group is. I guess also, just making sure as Jaylene puts it, pick up on that strength based narrative. We’re a story based culture, we used to pass on knowledge through story and it’s really important to – a lot of our stories are about empowerment, it’s not about do the wrong thing and this will happen. It’s not always that’s the case.
So, we’re really trying to pick up on positive messaging and get away from that deficit discourse that often happens around indigenous parenting or indigenous health, and try and tap into some of those cultural protective factors that are so important in our health and well-being. So, I’ll hand it over to someone else to add to that.
DANA SHEN: Thanks, Dave. Yeah, it’d be great, Jaylene, from your perspective as not only for young people, but as a young leader yourself, what is it that culturally responsive and cultural safety means for you?
TRISH RATAJCZAK: Like Dave said, it’s a very big discussion. But I think being culturally appropriate and safe, it’s just very simple. It’s taking recognition and recognising that Aboriginal people, we have different things, different perspectives, different ways of being, knowing. I say it’s simple because it really is that simple, different perspectives and respecting other people’s cultures and their perspective of life. Like law and lore, it’s different. Like Kartiya law, like white man law, isn’t taking it serious as Aboriginal lore.
So, the way that we act, the things that we do, it’s very different. So, approaching us and trying to get better, it will just make sense to approach us in the way of us knowing and us being. Because like, if we’re getting assessed, like say a mental health assessment, the last thing that we want to do is our intergenerational trauma being triggered by a non-Aboriginal person telling us that what we see and the way that we’re acting and the way that we perceive the world is wrong, and we need to be fixed. Like, it’s kind of that. It’s always a cycle, it’s always a circle. As much as we like to say that we’re aware, it does get filtered from the way that we’ve been brought up and the way that we perceive things.
So, I think being culturally appropriate and safe is just recognising and respecting and actually implementing it and taking it serious, that this is the way that our voices need to be heard, and we need to be taken seriously, especially our perspectives that we have, and our culture is very, very strong, and we could never abandon that in our blood and our soul, it’s an obligation to continue to have the perspective we do and just fight to be appreciated and acknowledged, especially when we’re trying to break cycles.
DANA SHEN: Great. Thank you, Jaylene. Finally, Trish, it’d be great for you to touch on that too. In terms of culturally responsive, cultural safety, but in particular how Baby Coming You Ready? is really trying to deal with that and work with that?
TRISH RATAJCZAK: So, I think Dave and Jaylene have really touched on it. It’s about being aware of how colonisation has really impacted into intergenerational trauma, so this can come out in the way that an Aboriginal woman or male has with their social emotional wellbeing and how it also may come out in the use of alcohol or maybe raging with their partner. All these are not our cultural practices, these don’t keep us strong. So, these are things that we are trying to help support with Baby Coming You Ready? in a cultural way of doing, which is our way of yarning and sharing stories. It’s really important to acknowledge that we need to have policies in place in health settings that actually support these cultural ways knowing of being, because we are tired of fitting into a white way of doing, we actually need for our ways to be acknowledged and to be supported in health scenes to ensure that our mob go back to services to get the support that they need desperately. We don’t need you to fix us, we want you to, like Jaylene said before, walk alongside us and support.
DANA SHEN: Great, thank you, Trish. Now, I do want to touch on, I said earlier it’d be great to understand some of the key elements in the tools that really speak to our people. So, I wondered, Dave, I know you’ve touched on a little bit on this already, but what do you think are the key aspects from both the SMS program, but also Wellbeing Mob that are trying to really speak to our people? What are those elements that our people can see that are us in it? I wonder if you could talk a little bit about that.
DAVID EDWARDS: Sure. I think it’s the cultural embedded element to those resources. Whether it’s a video, or an app that’s on Wellmob, and we’ve talked about the Stay Strong app, that’s a strength-based goal setting tool and has lots of Aboriginal lingo in there or nuances around what keeps you strong and some of the cultural practices, who keeps you strong and what are some of your goals and maybe some of your worries. We talk about worries instead of stress. Worry time. That language and connection and imagery is really important I think for the end user or communities to feel like it’s for them and it’s by them.
With SMS for Deadly Dads, again I mentioned about using plain language and having some content in there that we can associate with, whether it’s that shake a leg. There’s one message there about, “Hey dad, I’m as big as a football now and I can probably shake a leg.” So, things like that they can get a little bit of humour infused there as well as a visual of what it might look like when bubby’s growing. So, little things like that can help connect our end users, our communities with these resources. I think there is issues around literacy, both health literacy and English literacy. Some of our remote communities, English may be a third or fourth language or more. So, it’s really important to translate some of those complex health issues into bite size bits that have simple terms and are easy to understand and I think we’ve tried to do that with the Wellmob website by grabbing some of those infographics and video or audio-based resources.
I mentioned the iTalk studios which have great resources for children and adolescents. I think they’ve got 15 different indigenous languages they’ve developed some of their videos in. So, that’s really important to make sure we consider both English literacy and health literacy with our communities. Given schools weren’t a safe place for our people to attend right up until recently, it’s where children got stolen from. I guess we don’t typically engage in those mainstream forms of education that non-indigenous Australians might and there’s still that hang over that we’re seeing today. So, I think it’s really important we keep language simple and that we have some culturally embedded messages and some strength-based messaging in any health promotion or early intervention or prevention resource.
DANA SHEN: Thanks, Dave. How about you, Trish, it’d be great to hear in terms of Baby Coming You Ready? what were some of the key elements that have been built in that have really been led by community? What is it that they wanted in it and how was it reflected?
TRISH RATAJCZAK: One thing that community has really fed back is that they actually wanted clinicians to have a cultural train that is extensive. So, it’s not just a one-hour eLearning that they’ve done. So, embedded in Baby Coming You Ready? when a clinician is using Baby Coming with a mother, that they actually have to embed into or go through the Baby Coming You Ready? cultural eLearning, which is extensive. It’s eight hours, it’s long, but it is to help create that shift change and to actually for the clinician to have a reflection on their own cultural biases that they may be carrying. Because we want to make sure that, yes, you can have all these amazing tools but it’s the way they’re being used. So, really Baby Coming is driven by the woman, but we also need to make sure our non-Aboriginal allies they walk alongside us, are cultural appropriate and safe as well to ensure that security around the use of Baby Coming You Ready? Yeah, that’s just some of them.
But one of the other key factors is that they really wanted that power shift dynamic to happen, so that’s when Baby Coming is really driven by the woman and it’s actually what she identifies as David said, what her worries are, what are her strengths. What we do is we embed in what plans or supports she may need to create change in her life. This can also have a cascading impact on keeping her child with her and showing that she’s doing all the right things in her life. Reducing her alcohol use or cigarette smoking. But it’s not just about that, it’s also about highlighting her strengths. Because sometimes we don’t get told how strong and deadly, we are. We had one woman just say to me recently, she goes, “Trish, I’m more than a vessel, I’m more than just carrying a baby.” So, Baby Coming You Ready? wraps around that woman.
DANA SHEN: Fantastic. It really holds that, and I think one of things I think is so important about all of what you’re talking about is that importance of people feeling a sense of control, feeling a sense that they can do things and I will talk a little bit more about that and get your sense of that in a moment. But Jaylene, it’d be great to get a sense from you on, in terms of the tools that you’re working with what are the important elements in it, particularly for the young people in this particular app that you’ve talked about?
JAYLENE FRIEL: Yeah. It’s all strength based, I’m seeing there’s similarities with work that I do and Trish does and David does as well. It’s all the same concept, its strength based, it’s still the same that we’ve been doing for generations and generations. Like Trish said, it’s how someone used it. It’s a supported app, it’s depending on how willing both parties within the consultation is willing to understand both sides. Not only the person getting help, but the person that’s giving help, but mainly the person giving help. Yeah, the strength-based thing, the app, they go through the strength-based approach, which was a paper-based approach and the research that they’ve been doing here within the Stay Strong team has been decades.
When I was even born, I thought that was so interesting, they’ve been building rapport with the same places, the same people for years and years and that’s something like building that trust and that rapport. Giving and getting and sharing and actually trying to overcome the issues and having that strength base and just reminding young people, we are Aboriginal people, we are strong, like everything. Before everything happened, we were architects, we were the healers, we were everything before we got told that we weren’t and that we were doing everything wrong. It’s such an empowering – and giving that power to the young person instead of telling them this, this, this is what you need to fix. This is what you have, this is what’s wrong. This is how you can make better relationships, this is the way your behaviours aren’t right. Just the simplest things.
I think it’s quite simple because I understand what it’s like to be a young Aboriginal person. So, it could be unfair for me to say that it’s simple. But it really is that simple, it’s just to have an understanding and giving that power to the young person. Giving them power of their own mental health and their own will in this life, and to build themselves up and be equal to everybody else. Yeah,
DANA SHEN: Thanks Jaylene. Dave, I mentioned earlier it’d be great to chat a bit more about the journey of dads and men in this life, and particularly in the maternal health journey and the child’s journey. I wondered if you could just talk a little bit more about why it’s so important to build these sorts of tools, and ways of doing that, in order for that to happen.
DAVID EDWARDS: I mentioned before about how new dads are generally not likely to uptake on mainstream maternity health information sessions or visits. There is that cultural thing there too between men’s and women’s business. Like birthing itself is very much women’s business no matter what part of the country are we, remote or urban. But I guess our new dads in this last generation, there’s much more expectations on us to step up and be an active parent. That starts pre-conception, and we talked about these cultural practices involved and these connection to country that’s important when bubs born. We’ve often got mixed marriages or non-indigenous and indigenous partners. It’s really important to navigate that space sensitively but with that strength-based approach that our culture is a protective factor, and our culture is an important part of our children’s journey, and tapping into that culture can be an important part of their identity and their journey going forward.
I think it’s just really important that we get dads involved as much as we can in that antenatal and postnatal maternity visits system. Trying to make them feel welcome, asking dad questions, engaging them. The SMS for Deadly Dads is great, that gives men some information about what’s happening, and information is power. We talked about control and self-efficacy it’s so important to have some knowledge about what’s happening and particularly if you haven’t been exposed to it. I mean, a lot of our men do an amazing job and their cousins and their uncles and they’ve got babies around them. We have big families, we have our families early if you look at the stats. So, just empowering our men and making them feel welcome and invited into those discussions around child health.
It’s really important to acknowledge that a father’s role as an active father, an engaged father is a really significant advantage to child development. There’s evidence there to show brain development, all those stages of child development, if we’ve got an active dad it helps a child. Everything from rough and tumble play to other, and also just a functional partnership with the mum, trying to make sure it doesn’t matter if mum and dad end up separated, it’s important that dads stay engaged, and we try and reduce that cycle of dads being disengaged from their families because they’ve split. So, I think it’s really important to keep our men empowered and make them aware of their responsibilities and the positive role that they can plan in child development and supporting mum through that stage.
DANA SHEN: Thank so much, Dave. Look, a thing that has come a bit today and I just wanted to touch on how these tools are responding to it, is the challenge of the shame and stigma and the things that we can carry. Whether it’s mental health issues or other issues that we’re facing in our lives. Trish, I just wondered, in what way do you think Baby Coming You Ready? is really trying to support women and to challenge shame and stigma in this work? What’s your perspective on that?
TRISH RATAJCZAK: I think one thing is that there is no shame if you need support, and the way we’re doing that is by ensuring that women are taking control of that, rather than their clinician control of what they think is maybe being put in that woman’s life. We talked about self-efficacy that day, we touched on it’s really important that the woman feels empowered through that process, so that means that she’s coming up with supports that she may need in her family and actually for the clinician to recognise how important that here family is important her or being on country, or cultural practices that we have in our life that link our identity to country and to our wellbeing.
Sometimes clinicians are not aware of that and it’s not our place to be always having to educate them. But there is also, there’s no shame in if we have an issue with our emotional health wellbeing. But it’s also to have a recognition why that’s happened, why is that occurring. It could be like they’ve shared in the animation today that transgenerational trauma that has occurred. These are not things that are our fault. That’s happened to us, but we are standing here strong today and I have my ancestors behind me that are making strong, and making my daughter have strong health and strong wellbeing. Not our fault, but yeah, no shame.
DANA SHEN: Thanks so much, Trish. Now, one of the things I’d really like to do, or to make sure that we do before we come to close which is going to be in the next little while, but very soon. I really wanted to understand from your different perspectives, the work that you’ve done, particularly the tools, what are some of the key takeouts that you really want participants to have from this? What are the key learnings that you want them to take, in their work with Aboriginal and Torres Strait Islander people? So, Dave, I thought I would start with you. Any key takeouts that you’d really like participants to take from this?
DAVID EDWARDS: Just building rapport with your First Nations clients. I think it’s really important. It’s really difficult for clinicians when you’ve got time to consult and you’ve back-to-back appointments and to build in a little bit of space to get to know each other and to connect on that human level. Good ways to do that is through third party resources that we’ve mentioned. Looking at a video or looking at a PDF factsheet on a particular issue and talking through it together. Looking at what it might look like to use in the session. Whether it’s an app to monitors bub’s wellbeing journey, immunisation or care, and their growth and development, or whether it’s something to support the parent. It’s really good for practitioners to try and think about how they can use these online tools to better engage with their First Nations clients and people that they work with. I think just spending the time upfront to get to know people and to try and use some of those culturally embedded resources that are out there that make our mob feel a bit more comfortable in a clinical setting.
DANA SHEN: Thanks, Dave and you’re really emphasising that while these tools are super important and useful and they’re built by community, it’s actually also a lot about the relationship that people build with our community. That’s such a big part of this. Jaylene, how about for you, is there some key takeaways that you’d really want participants to have from this, from the work that you’ve done?
JAYLENE FRIEL: Yes. Well I’ve got a few key words that I wrote down actually. Two-way, like understanding the importance of two-way learning and understanding is very important. Especially when using a tool like Stay Strong. It’s like the go through the people that keep you strong, like Trish was saying, like family, number one. People that keep you strong, so that can be identifying worries. Next thing identifying strengths and then the final step being setting goals for change, having that. And holistic. Holistic is the most important way, I cannot stress it enough. Being holistic is so important and that rapport building. I understand that clinicians are very busy and health professionals are very busy and so much going on.
But just take a little bit of time to build that rapport and that trust because if you really want results in the work that you’re doing that’s the way blackfellas are. We need to trust you. Culture’s number one. Our law is number one. Not the systematic law that was brought here. Still to this day it’s not, law is number one, culture’s number one. If clinicians and stuff really want to change and to help people, Aboriginal people, is to understand that. We can’t work around culture, we can’t work around our soul, our spirit, we can’t work around it.
DANA SHEN: Brilliant, thank you, Jaylene. Trish, in brief, is there are couple of key points that you think I really want people to take away from today, from Baby Coming You Ready? any other work that you do?
TRISH RATAJCZAK: Yeah, I think it’s just you need to be self-reflective. You need to be examining your own cultural biases and how that may impact on your relationship with Aboriginal mob that are coming through your services. We’ve all touched on building a rapport, but that means about recognising our strengths and our resilience and also, that we need to have community ownership of what we’re doing in these spaces. Not the other way round. Just embrace our ways of knowing. Trust us. We’ve been here for a long time.
DANA SHEN: Yes and I think if I can just summarise some really key points from what all of you said. I think the first thing that I really heard was the importance of time and spending time with our communities. But also, when you talk about time, you talk about intergenerational time, in a number of the ways that you’ve done it. So, this is a long-term thing. If you want to work with our communities, it takes time, it takes long term. I think you’ve really pointed the importance of actually the focus of having community-led products. Where they’re actually there and sitting there in its own right, not an add-on, not an opt-in. But actually, it sits very separately in its own right. And finally, I think the couple of things that really spoke to me were about the importance of holism and actually being able to think about the dynamic of the strength and strength-based practices. You’ve talked in all different ways, including that culture is a protective factor for us.
So, on that little summary, I just wanted to thank all of our panellists. I want to thank Trish, Jaylene and Dave for their amazing contributions today and thanks to all of you for attending. This has been, as I said right at the beginning, a really big topic. We’ve only scratched the surface of it, there’s so much more to ask. But check out the handout section for more information. All the programs discussed today. The recording as I said earlier will be on AIFS website in about two weeks, with the extended Q and A for the questions from the audience, that we didn’t have time for today also answered. So, just as a reminder, if there was a question that you’re holding that didn’t actually get answered today, just know that we’re going to do our best to respond to as many questions as we can following the live session.
Again, there’s a short survey, it will be available right after the webinar today. Your feedback on that would be really important to us, so please let us know what you think, so we can learn from that and do more and do different based on all your feedback. Overall, I hope all of you will take care and we know we discussed some really hard things today, but also there’s a lot of hope too. You can see it in our young people. Like Jaylene, you can see it in our leaders like Trish and David. So, hold onto that as well as you all do that work. So, on that I just wanted to say a thanks to all of you for joining today and to really wish you the best for the rest of the day and for 2023 as well. Thank you again, so much for joining us all.
Dave, I wonder if I could start with you with SMS for Deadly Dads. Some questions have come through around whether stillborn or pregnancy loss is actually a consideration in this tool. I wondered if you could talk a little bit to that?
DAVID EDWARDS: It’s a good question. We’ve actually just developed a whole new range of message sets, so text messages relating to a father that’s experienced a miscarriage, a baby that’s ended up in the neonatal ward. So, premature birth, as well as a stillbirth. Those messages, and those programs are going to be launched in the fourth of May in Melbourne. Once those programs have been launched, when dads do go onto the SMS for Dads website, they can choose to actually enrol in either of those programs specific to what’s happened. Or if they’re currently receiving messages and they have the unfortunate event of losing a baby, they can actually text back and it automatically triggers a new message set.
So, once those message sets are available, those experiences will be catered for. Those messages have been developed by our collaborators at Red Nose and PANDA, Perinatal, Anxiety and Neonatal Depression Australia, to make sure that dads have some support when they go through those tough issues.
DANA SHEN: Fantastic. Thank you so much, Dave. Trish, I just want to go to you now. There’s actually a lot of questions coming through about Baby Coming You Ready? So, I’ll just run through these with you, just to get your feedback for our listeners. So, first of all, one of the questions that’s come up is about location. Where is it available and who can access it and how it can be used at the moment? Trish, could you start with that one?
TRISH RATAJCZAK: Sure, Baby Coming You Ready? at the moment’s in pilot stage. So, it’s currently based here in Perth WA Noongar Boodjar. So, we have numerous sites here and progressing forward we actually are going up to the Pilbara, to help saturate that area with Baby Coming You Ready? But we also have been successful in grants through re-planting the birthing trees. So, that’s in Melbourne. They will have some site over there that will have Baby Coming You Ready? which is not being chosen as such as yet, but it will be kind of nut down a bit more. We also have just been successful with iCare grant over in South Australia. So, some locations will be chosen over there as well with Baby Coming You Ready? be rolled out.
So, for now it’s very successful and everyone wants it but we’re trying to be mindful of rolling it out slowly to what community wants and adapt it to each community’s needs. So, that means engaging with elders in communities and community members and finding resources that can support Baby Coming You Ready? with the use through these health services.
DANA SHEN: Fantastic. So, another issue that’s also come up is around the concept of screening. So, people have asked questions around screening, but I understand that really Baby Coming You Ready? deals with this in quite a different way, in terms of learning from people. I wondered if you could talk a bit more about that.
TRISH RATAJCZAK: There’s a language of using screen or assessment tools as such is one way to really scare mob away, because that is associated with lots of negativity in regards to maybe that the child has been removed or involvement with Department of Children Services. So, through Baby Coming You Ready? we do talk about alcohol, smoking and drugs, and also family and domestic violence. But it’s done our way. So, this is through the imagery, through the minimum select that she may have – what her attitude is with her partner. It may be a really solid strong partnership, but it also might be a partner that is maybe moody or jealous. So, then when the women selects those images they will trigger to the next stage where it may then also go onto how does this relationship look for her. This may be that her partner maybe controlling, or he might unfortunately hit her, or hit the children.
So, then that is a trigger to highlight that is family, domestic violence in that context. Then that will then come through the rubric, as you progress through and come up as a worry for the woman. So, she can select that if it’s a worry to her and then the clinician could help support around that woman. It’s the same with alcohol and smoking as well. So, questions are asked about how much alcohol you may be drinking, how many cigarettes your having, but also in regards to social, emotional wellbeing the Kessler K-5 too is used. That includes if you have been – it’s not like you wanted to take your own life. So, those sensitive topics are all included in Baby Coming You Ready? But this is all done through a yarning methodology and ways of being that it’s embedded in our culture.
DANA SHEN: Thanks, Trish. And finally, a question that’s come through is really around access in rural and remote settings. I just wondered on the potential of Baby Coming You Ready? being able to do that.
TRISH RATAJCZAK: Yeah. So, as I touched on before, we are going up to the Pilbara and that will mean that Baby Coming You Ready? is very adapted to different language groups. So, we can take images out and we can replace it with different language groups for the communities that we’ve got. So, we’re fortunate it’s very adaptive. So much so that non-Aboriginal people really want it, then other language groups that are not Aboriginal as well. But it is for Aboriginal communities and it’s very adaptive, and this how we’re going up to the pilot to see how it works in those communities and what community wants. So, that will help us with the roll-out into differing sites as well. So, all again controlled by community and community led.
DANA SHEN: Fantastic. Thank you so much. Dave, I just wanted to ask a quick question about Wellmob. There’s actually quite a lot of queries about the kinds of resources available for ADHD, autism, domestic and family violence, etcetera. I just wondered if you could speak to how people can find that information on Wellmob.
DAVID EDWARDS: We’ve tried to make it really easy for workers and communities to find resources on all those topics. So, you can either just do a keyword search, using the main search bar either in the top right corner of the landing page of the website, or down the middle of the website under the six main topic tiles. For those specific health issues there are actually subcategories. So, for instance, family and domestic violence we’ve got something under keeping safe, there’s a subtopic under there which I think it’s got several resources. I know half of them are videos which are great to use with families and children to talk about those sensitive issues. Sexual Health, if you go under body there will be stuff under sexual health as well as for you people under our mob.
So, it’s a matter of either just doing a general search of going under those six main topic tiles and the associated sub-topics. On sexual health is some great stuff there that New South Wales Family Planning have just put out. Some PDFs that are really infographic style and made for both boys, girls, workers, educators to use with young people around sexual health. So, any of those topics you’ll be able to find some resources that will suit your context.
DANA SHEN: Fantastic. Thanks so much, Dave. Now, Jaylene, one of the questions that’s come through is really trying to understand more about the principles that underpin these kinds of tools and products, and I thought it would be great if you could talk a little bit more about the four-step approach, Stay Strong approach. I wonder if you could take us through that.
JAYLENE FRIEL: So, those Stay Strong approaches, basically the same approach in every app, and in fact, the key concept around majority of our resources – so it’s a four-step approach. The first one being identifying family or identifying people that keep you strong. The second being identifying worries, and the third about identifying strengths, and the fourth being setting goals for change. In those, they have the two middle steps, so the identifying strengths and worries. They’re both a metaphor referring to a tree. In the strengths one, under it there’s a phot of a tree and then you’re able to select what the strengths are of the person that you’re consulting with, or the young person. Then each time you choose a strength, from the root all the way to three leaf it gets stronger, so that is a metaphor of seeing how the tree grows stronger and what things that you do in your life that make you stronger as a person and more grounded.
The worries is kind of the same thing, but every time you highlight a leaf of what worries you may be going through. Each leaf represents each different aspect, one being spiritual connection, one being social, the next being physical and I believe the last one is – yeah, social and emotional, physical, spiritual. Yeah, those are the concepts that are there. Then, each time you – like, which one’s a worry, the tree would weaken or the strengths, it will strengthen. And the last one is setting goals, is also a metaphor to footy. So, like some goal posts, so those are the three metaphors that are embedded in that app and the approach.
DANA SHEN: Beautiful. So, it’s really kind of drawing on that issue of how we grow as beings, which I love through the tree, and of course sports such a big thing in our community, so being able to draw up that as well. That’s wonderful. Thanks so much, Jaylene.
Trish Ratajczak is Palawa woman from Lutruwita (Tasmania) with connections to descendent Mannalargenna chief of the Pairrebeene/Trawlwoolway Clan. Trish is a Senior Research Officer at Ngangk Yira Institute for Change at Murdoch University in Western Australia and co-lead for the Baby Coming You Ready program. She is a registered clinical midwife of 13 years in the tertiary setting and has been a strong advocate and educator for upcoming health professionals on Aboriginal health and culturally security in universities in Western Australia. She is also an early childhood educator and is committed to supporting positive impact and change with Community at every opportunity
David Edwards is a Worimi man and Director of the WellMob website under the e-Mental Health in Practice (eMHPrac) project. David is a Lecturer at the University of Sydney for Rural Health in Lismore NSW. He is also part of the SMS4DeadlyDads team at the University of Newcastle, co-developing resources for Aboriginal and Torres Strait Islander dads. David is also a Facilitator Trainer for the Core of Life education project creating culturally safe spaces for young people to yarn about pregnancy and birth.
Jaylene Friel is a Murrinh-Patha & Arrente young woman who works at the Menzies School of Health Research in Darwin. She is a Youth Project Officer who works with community to develop, test and train health professionals in using digital mental health tools in their practice, focusing on the Aboriginal and Islander Mental health initiative (AIMhi) Stay Strong app, and the newly developed Youth Stay Strong App (AIMhi-Y).
Dana Shen is Aboriginal/Chinese and a descendant of the Ngarrindjeri people in South Australia. Dana has 20 years’ experience working across the public and not for profit sectors in the areas of health, families, and child protection. She also has extensive experience in facilitation, service design, Aboriginal cultural consultancy, mainstream service delivery and systems change.