For the cost of a cup of coffee you can put an Indigenous medical student through university

The AMA Indigenous Medical Scholarship supports Aboriginal and Torres Strait Islander students to study medicine and achieve their dream of becoming doctors.

Each year, the AMA offers one Scholarship to an Aboriginal and/or Torres Strait Islander student studying medicine at an Australian University, but with the help of your tax deductible donation, we can increase the number of Scholarships offered each year and help grow the Indigenous medical workforce.

Indigenous doctors have a unique ability to align their clinical and sociocultural skills to improve access to services, and provide culturally appropriate care for Aboriginal and Torres Strait Islander people. Yet, Aboriginal and Torres Strait Islander doctors comprise less than 1 per cent of the entire medical workforce.

Since its inception in 1994, the AMA Indigenous Medical Scholarship has helped more than 20 Indigenous men and women become doctors, many of whom may not have otherwise had the financial resources to study medicine. The AMA hopes to expand on this success and increase the number of Scholarships on offer each year to meet a growing demand for the Scholarship.

By supporting an Indigenous medical student throughout their medical training, you are positively contributing to improving health outcomes for Aboriginal and Torres Strait Islander people.

If you are interested in making a contribution, you can do so by downloading the donation form at: donate-indigenous-medical-scholarship. Further information about the Scholarship go to: advocacy/indigenous-peoples-medical-scholarship.

For enquiries please contact the AMA via email at indigenousscholarship@ama.com.au or phone (02) 6270 5400.

Donate to the AMA’s Indigenous Medical Scholarship Today!

13 Reasons Why – suicide the last taboo

13 Reasons Why is a Netflix TV drama about a troubled teenager who takes her own life, having beforehand recorded 13 tapes explaining the ‘reasons’ for her suicide. The show is based on ayoung adult best-selling novel by Jay Asher.

This TV show has generated controversy over its theme of teen suicide, depicting suicide ‘method’, and the graphic depiction of rape. Debate on the program content, and the reaction from suicide prevention and mental health organisations, has created an international furor. Headspace, the National Youth Mental Health Foundation providing early intervention mental health services to 12-25 year olds, issued a warning about the show’s “dangerous content” and labelled the program irresponsible for depicting suicide methods. Headspace said it “exposes viewers to risky suicide content and may lead to a distressing reaction by the viewer, particularly if the audience is children and young people.” A critic on MamaMia, Australia’s largest independent women’s website, described the show as “a suicide manual”.

Other critics point out that 13 Reasons Why does not conform to the guidelines on safe and responsible reporting on suicide. Mindframe, who provide information to support the reporting, portrayal and communication of suicide, said the TV drama “sends the wrong messages about suicide risk and the show does nothing to encourage help-seeking.”

There is no question that 13 Reasons Why is confronting viewing; with graphic messages and imagery of suicide methods. Most troubling for many suicide and mental health experts, it does not present options for troubled teens. This is the view of leading cultural magazine Rolling Stone: “Had 13 Reasons Why showcased other forms of outreach, like therapy, teens watching it might realize that there is always an option that doesn’t include self-harm.”

In a Vanity Fair interview, scriptwriter Nic Sheff (who incidentally has spoken of his own suicide attempts) defended the show’s direct approach: “Facing [suicide] head-on … will always be our best defense against losing another life. We need to keep talking, keep sharing, and keep showing the realities of what teens in our society are dealing with every day. To do anything else would be not only irresponsible, but dangerous.”

Many websites discussing the pros and cons of this controversial series agree that it is leading to a wider discussion about teenage issues and how parents can talk with the children about suicide and self-harm. The Sydney Morning Herald reviewer described the show as an “unflinching but unexploitative portrayal … 13 Reasons Why is extremely tough viewing at times … It’s strong stuff that works hard to shatter pernicious assumptions.” The New York Times commented: “The overall message — one that probably appeals to teenagers — is that it’s possible to figure out why someone takes her own life, and therefore to guard against it happening to others.” The Guardian, by contrast, deplored the series as “horrifying”. The New Yorker, in a scathing assessment, raised a crucial issue, namely that the series does not address mental illness, and presents “suicide as both an addictive scavenger hunt and an act that gives … glory, respect, and adoration that was denied in real life.”

The debate over 13 Reasons Why is, in essence, whether teenage suicide is a subject matter to be graphically depicted in a popular teen drama, whether the modern appetite for ‘binge’ watching allows young viewers to properly understand and discuss the issues (and seek appropriate counseling and guidance), and whether a slick, glossy TV series can inadvertently present suicide as ‘normal’, even glamorous.

Conversely, as others have advanced, we shouldn’t make suicide, especially youth suicide, a taboo issue. By bringing it out into the open (and the show is based on a popular book that caused few ripples when it was released) we open a gateway into a most confronting and all too real issue for young people.

It’s too early to assess the impact of this show on young viewers, but it does appear that how we discuss youth suicide has been changed.

Simon Tatz
Director, Public Health

Increasing funding to improve outcomes for eating disorders

The Federal Budget allocated $80 million for Australians with a mental illness such as severe depression, eating disorders, schizophrenia and post-natal depression resulting in a psychosocial disability, including those who had been at risk of losing their services during the transition to the NDIS.

The Government also announced it will provide $9.1 million over four years to improve access to psychological services through telehealth in regional, rural and remote Australia.

Health Minister Greg Hunt has also freshly announced that eating disorders will be included in the 5th Mental Health Plan and that the current Medicare Benefits Schedule Review Taskforce investigate Medicare coverage for the treatment of those with an eating disorder.

The National Mental Health Commission described the funding announcement as timely.

“Timely that eating disorders will be recognised officially as serious and complex mental illnesses with serious physical consequences,” said the Commission’s chief executive Peggy Brown.

The Butterfly Foundation, which is the country’s peak support organisation for people with conditions such as anorexia and bulimia, says that the current health system is failing people with an eating disorder.

Its chief executive, David Murray, said: “Too many times in the past 12 months Butterfly staff have sat vigil with families as the health system has failed.”

“When suicide is up to 31 times more likely to occur for someone with an eating disorder, clearly the Government should address this problem with a dedicated focus.”

According to the National Eating Disorders Collaboration (NEDC), an initiative of the Australian Government Department of Health, more than 1 million Australians suffer from eating disorders and represent the third most common chronic illness for young females.

The NEDC also cites research that shows anorexia has the highest death rate of any mental illness and carry a very high rates of mortality with one in 10 people who suffer from an eating disorder dead within 10 years.

Deaths associated with eating disorders are typically caused by medical complications (such as cardiovascular issues and multiple organ failure), suicide or complications relating to substance use.

A 2012 Deloitte Access Economics report examined the economic and social impact of eating disorders in Australia and found the total socio economic cost of eating disorders to be $69.7 billion per year. These costs can be reduced with early detection.

The Australian Medical Association believes that a greater focus is needed on ensuring appropriate access to early intervention and treatment services for young people especially in rural and remote locations. The AMA also believes that a nationally coordinated approach is necessary in order to develop effective and consistent practices in preventing and addressing the incidence of unhealthy body image and eating disorders.

If this article has raised concerns about eating disorders, please contact the Butterfly Foundation national hotline on 1800 33 4673; or visit www.thebutterflyfoundation.org.au for support and resources for eating disorder sufferers and their families and carers.

Meredith Horne

Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2015–16

This is the eighth national report on organisations funded by the Australian Government to provide health services to Aboriginal and Torres Strait Islander people. In 2015–16: 204 organisations provided primary health-care services to around 461,500 clients through 5.4 million client contacts and 3.9 million episodes of care; 216 counsellors from 93 organisations provided social and emotional wellbeing services to around 18,900 clients through 88,900 client contacts; 80 organisations provided substance-use services to around 32,700 clients through 170,400 episodes of care.

National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results from June 2016

This fourth national report on the national Key Performance Indicators (nKPIs) data collection is based on data from more than 240 primary health care organisations that received funding from the Australian Government Department of Health to provide services primarily to Aboriginal and Torres Strait Islander people. Information is presented for 22 ‘process-of-care’ and ‘health outcome’ indicators for June 2016, which focus on maternal and child health, preventative health, and chronic disease management. The report shows continuous improvements for the majority of indicators.

Federal money announced for doctors’ mental health

Health Minister Greg Hunt will work directly with doctors to develop a mental health care package for the medical profession.

Addressing the AMA National Conference on May 26, Mr Hunt (pictured) said a recent spate of young doctor suicides – including that of Deputy Chair of the AMA Doctors-in-Training Council Dr Chloe Abbott – has been a cause for great concern.

The Minister said that after speaking with AMA President Dr Michael Gannon and former President Dr Mukesh Haikerwal, he was determined to develop a mental health package targeting doctors.

“One of the main things we introduced in the Budget was prioritising mental health. For the first time, this has been raised to the top level as one of the four pillars of the long-term national health Plan,” Mr Hunt said.

“And we were able to invest significantly in mental health, both in the election, but in particular, in the Budget as well. There’s a very strong focus on suicide prevention with support for suicide prevention hotspots and an $11 million initiative, but also complementing that with the rural telehealth initiative for psychological services.

“Much of this is deeply important preventive health work on the mental health side and it goes with what has to happen in, I think, the medical work force. The case of Chloe Abbott was outlined and I’m aware that many people have been affected by Chloe’s loss, as well as others.

“And Michael and I have been speaking this week, and also been speaking in recent weeks with Mukesh Haikerwal, and I am determined to offer a partnership with the Government and the AMA for us to provide new investment directly into caring for carers.

“And so I want to announce that we will offer a partnership going forward and we will develop the suicide prevention, mental health programs with the AMA and the broader medical work force for suicide prevention and mental health support, specifically for doctors and other medical work force professionals.

“One of the critical roles that you have is psycho-social services. There’s the clinical work with those with mental health issues, but then there is the support services.”

The Minister offered few details of the partnership, stressing that it was still in its conception stage.

But he was determined to take action.

Following his address to the conference, he spoke more to the media about the plan.

“There have been some terrible tragedies in the sector. Michael Gannon and other doctors, Mukesh Haikerwal, have talked to me about that,” he said.

“What we’ll be doing is developing a caring for carers package which will be assisting with specialist channels, because sometimes, and this is what’s been explained to me, those who are doctors or nurses (a) will feel that they shouldn’t be seeking help even though they’re just the same as everybody, and (b) they might feel professionally uncomfortable. Even though they might be in the depths of despair they’ll still feel that professional discomfort at reaching out.

“And so if they have some specialised services for them then they will feel more comfortable, we hope, and that’s what’s been proposed by the profession.”

He did not know if the plan would address the mandatory reporting lines, where doctors might fear they would be reported to the Medical Board when they seek help.

He also promised funds to the partnership, but could not say how much at this stage.

“There’s been no proposal put to me yet, but as I’ve said, in designing of this, what I really want to do is work with the AMA and the GPs,” he said.

“What we’re doing is we’re designing together, and from that we’ll have the outcome.”

This article was originally published in Australian Medicine. Read the original piece here.

Doctorportal hosts a dedicated doctors’ health service providing support in the medical community.

Indigenous eye health measures 2016

This is the first national report on 22 newly developed Indigenous eye health measures. The measures cover the prevalence of eye health conditions, diagnosis and treatment services for Aboriginal and Torres Strait Islander Australians, the eye health workforce and outreach services. Subject to data availability, the report examines differences between Indigenous and non-Indigenous Australians, as well as differences by factors such as age, sex, remoteness, jurisdiction and Primary Health Network.

[Comment] Optimising care for children with kidney disease

The theme for World Kidney Day in 2016 was “kidney disease and children: act early to prevent it”. Given the adverse effect of renal replacement therapy—dialysis and transplantation—on quality of life and health care resources, few would disagree with this ambition. For some children, however, end-stage kidney disease cannot be avoided and its effects have to be managed and outcomes optimised. With increasing fiscal pressures on health services in many settings around the world, the Article in The Lancet by Nicholas Chesnaye and colleagues looking at macroeconomics and survival on renal replacement therapy in Europe is timely.

Caring for the carers partnership to be developed

Health Minister Greg Hunt will work directly with doctors to develop a mental health care package for the medical profession.

Addressing the AMA National Conference on May 26, Mr Hunt said a recent spate of young doctor suicides – including that of Deputy Chair of the AMA Doctors-in-Training Council Dr Chloe Abbott – has been a cause for great concern.

The Minister said that after speaking with AMA President Dr Michael Gannon and former President Dr Mukesh Haikerwal, he was determined to develop a mental health package targeting doctors.

“One of the critical roles that you have is psycho-social services. There’s the clinical work with those with mental health issues, but then there is the support services.”

The Minister offered few details of the partnership, stressing that it was still in its conception stage.

But he was determined to take action.

Following his address to the conference, he spoke more to the media about the plan.

“There have been some terrible tragedies in the sector. Michael Gannon and other doctors, Mukesh Haikerwal, have talked to me about that,” he said.

“And so if they have some specialised services for them then they will feel more comfortable, we hope, and that’s what’s been proposed by the profession.”

He did not know if the plan would address the mandatory reporting lines, where doctors might fear they would be reported to the Medical Board when they seek help.

He also promised funds to the partnership, but could not say how much at this stage.

“There’s been no proposal put to me yet, but as I’ve said, in designing of this, what I really want to do is work with the AMA and the GPs,” he said.

“What we’re doing is we’re designing together, and from that we’ll have the outcome.”

Chris Johnson

Shorten says Government trying to silence doctors

AMA President Dr Michael Gannon assured delegates to the National Conference the association is independent and not “reading from the script any political party”.

His comments followed a conference address by Opposition Leader Bill Shorten, who suggested the staged thaw of the Medicare rebate freeze – as outlined in the Federal Budget – was the Government’s way of offering “cash for no comment”.

“If you like, it’s the minimum they can get away with paying to keep people silent,” Mr Shorten said.

“It’s like cash for no comment.

“I believe the Government has got a calculus here. What is the minimum they can pay to make healthcare issues go away as an election point?”

The Opposition Leader insisted his comments were a swipe at the Government and not at the AMA or other medical groups.

But when asked about it in a subsequent panel session, Dr Gannon told the conference the AMA engaged with all political parties equally and was not influenced by policy announcements.

“They’re in for a surprise if they think they can keep the AMA quiet,” he said.

Health Minister Greg Hunt agreed that the AMA was independent and told reporters that if Mr Shorten was attacking the AMA it was a “vile” thing to do.

Greens leader Richard Di Natale, who also spoke at the conference and delivered his own veiled criticism over recent commentary around climate change, said Mr Shorten’s remarks were directed at the AMA.

“How else would you construe it?” he told the media following his address.

“Now, I think the unfreezing of the rebate is happening way too slowly. But what the AMA does in response to Government policy is a matter for them.”

The May Budget lifts the Medicare rebate freeze, which was introduced by Labor and extended when the Coalition came to office. But it does it in stages – starting this year with bulk-billing incentives for GPs, continuing with other GP specialist consultations in 2018, specialist procedures in 2019, and diagnostic imaging services in 2020.

Mr Shorten released to the conference new independent costings of the rollout, which he said amounts to $2.2 billion in Medicare cuts over four years.

He said the Parliamentary Budget Office analysis showed that by completely lifting the freeze across the board from July 1 this year it would have cost $3.2 billion.

Doing it the way the Budget outlines, costs less than $1 billion.

Shadow Health Minister Catherine King also addressed the AMA National Conference and repeated Labor’s commitment to end the Medicare rebate freeze completely and all at once.

Chris Johnson