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Housing and infrastructure for Aboriginal Peoples living with mental illness and/or psychosocial disability: Submission to the Parliament of South Australia’s Social Development Committee Inquiry into the provision of services for people with mental illness under the transition to the National Disability Insurance Scheme (NDIS)

Authors:
Submission to the Parliament of South Australia’s Social Development
Committee Inquiry into the provision of services for people with mental
illness under the transition to the National Disability Insurance Scheme
(NDIS)
Elizabeth Grant and Scott Heyes
Housing and infrastructure for Aboriginal
Peoples living with mental illness and/or
psychosocial disability.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 2
2018 Elizabeth Grant and Scott Heyes
The University of Canberra,
Faculty of Arts and Design, Bruce ACT 2617
Contact
Email: Elizabeth.Grant@canberra.edu.au
Tel: 0404365833
Cover Image: Aboriginal person in the South Australian Prison system after self-harm incident. From exhibition:
No More Than What You See by Ricky Maynard.
RECOMMENDED REFERENCE
Grant, E. & Heyes, S. (2018). Housing and infrastructure for Aboriginal Peoples living with mental illness and/or
psychosocial disability: Submission to the Parliament of South Australia Social Development Committee
Inquiry into the provision of services for people with mental illness under the transition to the National
Disability Insurance Scheme (NDIS), Barton: The University of Canberra.
NOTE ON TERMINOLOGY
In this submission, the term ‘Aboriginal’ and ‘Indigenous’ are used inclusively to refer to Aboriginal and Torres
Strait Islander peoples.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 3
Contents
About the authors ................................................................................................................................................ 4
Introduction .......................................................................................................................................................... 6
Underreporting of Indigenous disability .............................................................................................................. 6
Definitions of mental illness and/or psychosocial disability ................................................................................ 7
The importance of appropriately designed, culturally appropriate housing ....................................................... 7
Access to housing for Indigenous peoples living with mental illness and/or psychosocial disability .................. 8
Housing design for Aboriginal peoples with mental illness and/or psychosocial disability. ................................ 9
Summary and recommendations ......................................................................................................................... 9
References .......................................................................................................................................................... 11
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 4
About the authors
Dr Elizabeth Grant is an architectural anthropologist, criminologist and academic with a distinguished record
in the field of Indigenous Architecture. She holds an adjunct Professorship at the University of Canberra an
adjunct Associate Professorship at the University of Queensland, and is a visiting scholar to Cambridge
University.
Elizabeth is an international expert in humane court, police and custodial design and housing for Indigenous
peoples living with disability. A Churchill Fellow, among other awards she was honoured with the International
Prison and Correctional Association (ICPA) Excellence in Research Award for her pioneering research. In 2017,
she was invited to submit to three Government inquiries and appointed as an expert witness and participant
for closed forums for the Royal Commission into the Protection and Detention of Children in the Northern
Territory. In 2018, she presented to the NDIS Ministerial Taskforce and appeared before the Senate Joint
Standing Committee on the National Disability Insurance Scheme to discuss the housing needs of Indigenous
peoples living with disability, and was appointed as an international expert to Aotearoa New Zealand’s Hāpaitia
te Oranga Tangata Criminal Justice Summit.
Elizabeth was the lead researcher on an Australian Housing and Urban Research Institute (AHURI) (2014-2017)
study entitled: Housing and Indigenous people living with a disability: lived experiences of housing and
community infrastructure using Yalata (SA), Point Pearce (SA) and Geelong (Vic) as remote, rural and urban
case studies. The housing and community infrastructure needs of this population group had not been
previously studied, and the research shed much needed light on the nexus between lived experiences of
disability and housing among Indigenous Australians in order to inform how the NDIS could best meet the
needs of this overlooked group within the population.
She has published four books and over 70 papers and is the lead editor of the International Handbook of
Contemporary Indigenous Architecture (Springer 2018). The handbook provides the first comprehensive
international overview of contemporary Indigenous architecture, practice, and discourse, showcasing
established and emerging authors and practitioners from Australia, Aotearoa New Zealand, the Pacific Islands,
Canada, USA and other countries.
Elizabeth is an elected member of Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS),
a member of the International Association for People-Environment Studies (IAPS), the Environmental Design
Research Association (EDRA), the Architectural Humanities Research Association (AHRA), the Native American
and Indigenous Studies Association (NAISA), the Australian New Zealand Society of Criminology (ANZSOC), the
Australia and New Zealand Chapter of the Association of Critical Heritage Studies and the Expert Panel of the
International Corrections and Prisons Association (ICPA).
Dr Scott Heyes is an Associate Professor and Convener of Landscape Architecture in the School of Design and
Built Environment, Faculty of Arts and Design at the University of Canberra, Australia. He holds prestigious
research associate positions at the Smithsonian Institution’s Arctic Studies Center in Washington D.C., and at
Trent University’s Frost Centre for Canadian and Indigenous Studies in Canada. His research and teaching
interests centre on Indigenous knowledge systems and Indigenous heritage issues in Indigenous Australia, Fiji,
and the Inuit homelands of Arctic Canada.
Scott’s research, teaching and engagement activities have centred on several collaborative projects with
Indigenous communities and industry partners spanning more than fifteen years. The projects have been
carried out in Australia, the Arctic and the Pacific using ethnographic and participatory methods. These projects
have led to traditional research outputs in the form of co-publications and conference papers with research
partners, as well more creative outputs in the form of short films, design studios, design works, maps, and
major exhibitions.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 5
Scott has championed Indigenous issues on campus by leading student field trips to Indigenous communities
in South Australia, Queensland, NSW and Fiji, and by advocating for expanded teaching of Indigenous
knowledge across the disciplines of design. He teaches across the disciplines of landscape architecture and
cultural heritage, with the subject content being drawn directly from his research projects, and with Indigenous
community support. In recognition of the significant impact of his activities with Indigenous partners, Scott
was awarded a University of Canberra’s Vice-Chancellor’s Excellence Award for Research in 2015, and a Vice-
Chancellor’s Excellence Award for Equity and Diversity in 2014
Scott has presented his research to a range of audiences in Africa, North America, Europe, Pacific countries,
and throughout Australia. He serves annually as an international reviewer for the Canadian Government’s
Social Science and Humanities Research Council, and has served on the University of Canberra’s Human
Research Ethics Committee since 2012. He is a member of anthropology and geography associations in
Australia, Canada, and the USA. He currently serves as a peer reviewer for seventeen international journals in
the disciplines of landscape architecture, Indigenous studies, geography, heritage, political science, and
anthropology. Scott is an external advisor for the ARC Linkage project Creative Barkly, led by Griffith University
and he serves as an expert advisor for the Kokoda Track Military Heritage Plan, by appointment from the PNG
National Museum and Art Gallery. He is actively involved in designing environmental history projects with Rural
Communities Australia his capacity as an Advisory Board Member.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 6
Introduction
This submission is made on the call by the Parliament of South Australia’s Social Development Committee
Inquiry into the provision of services for people with mental illness under the transition to the National
Disability Insurance Scheme (NDIS) and address the terms of reference which state:
The Committee inquire into, and report on the provision of services for people with mental illness under
the transition to the National Disability Insurance Scheme (NDIS) with particular reference to:
1. The gap between the Federal Government’s predicted and realised percentages of mental health
clients receiving NDIS support;
2. The reduction in funding to the Personal Helpers and Mentors program and Mental Health Respite
Carer Support program and the impact this will have on people with mental illness;
3. The ongoing requirements for block funded mental health services provided by the State Government
after the NDIS transition;
4. The effects on South Australians with mental health issues who are deemed ineligible to receive NDIS
funding;
5. The sufficiency of services provided to people with mental illness who are accepted into the NDIS;
6. The effects on South Australians with mental health issues undertaking the application process for
the NDIS;
7. Any other relevant matters.
This submission draws on research conducted in an Australian Housing and Urban Research Institute (AHURI)
longitudinal study entitled: Housing and Indigenous people living with a disability: lived experiences of housing
and community infrastructure (attached as appendices 1 & 2), and other work by the authors.
Underreporting of Indigenous disability
The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) noted that 65% of the Aboriginal and
Torres Strait Islander population reported having a long-term health condition, including 29% who reported a
diagnosed mental health condition (25% of males and 34% of females). This is likely to constitute an
undercount. Underreporting or non-reporting of disability within the Indigenous population appears common
due to historical, cultural and linguistic factors. Much of the literature indicates that Australian Bureau of
Statistics (ABS) figures are the ‘tip of the iceberg.’ The National People with Disabilities and Carer Council
(NPDCC), the Australian Productivity Commission, the First Nations Disability Network and the Australian
Institute of Health and Welfare (AIHW) have all questioned the accuracy of the current data on the prevalence
of disability within the Indigenous population (Grant et al. 2017).
Reporting of disability among Indigenous people is influenced by cultural factors. Some Indigenous Australians
find the concept of disability difficult to understand or irrelevant, thus reducing the likelihood that the surveys
accurately record the prevalence of mental illness and/or psychosocial disability. In some Aboriginal
communities there are diverse and complicated understandings of the emergence and presence of disability.
There is some evidence that because of fear of stigmatisation or discrimination some Indigenous people
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 7
choose not to identify as having a disability. There may be a stigma attached to the terms ‘mental illness’ and
‘disability’, or mental illness or psychosocial disability may be considered a result of ‘married wrong way’ or
magic or sorcery. Other Aboriginal communities accept behaviours related to a mental illness or psychosocial
disability as inherent traits of the individual. Many Aboriginal people understand disability from a Western
scientific medical standpoint, focussing on physical or visible types of impairments and failing to recognise
mental illness or cognitive deficiencies as a type of disability.
All of these factors can result in serious non or underreporting of mental illness or psychosocial disability in
Aboriginal populations. While Indigenous people may choose not to identify as living with a disability, there is
evidence that Indigenous people are living with high levels of distress as a result of their circumstances and
health conditions. ABS data reports some 30 per cent of Aboriginal and Torres Strait Islander adults report
levels of high or very high distress while only 11 per cent of non-Indigenous adults report the same (2016).
Definitions of mental illness and/or psychosocial disability
Physical disability is comparatively well defined for Aboriginal peoples under the NDIS. However, chronic
diseases, mental illness, psychosocial disability and other comorbidities need to be considered in NDIS
assessments for Aboriginal peoples. Assessments need to be holistic and consider the interplay of other
conditions, especially:
1. Complex health conditions
2. Drug psychosis
3. Cognitive function
4. Learning disabilities
5. Grief and loss issues
6. Depression and anxiety
7. Foetal Alcohol Syndrome
The cultural nature of mental illness and/or psychosocial disability is currently not covered under definitions
contained within NDIS legislation and as a result many Aboriginal people are unable to assess services under
the NDIS criteria.
It is imperative that the definition of mental illness and psychosocial disability be revised to consider the
interplay of health and social issues, which impact on the psychological wellbeing Aboriginal peoples. A more
holistic appreciation of these issues will enable great access to NDIS services.
The importance of appropriately designed, culturally appropriate housing
Having access to appropriate housing is integral to the physical and mental wellbeing of Indigenous people and
people with disability (Grant et al. 2014). Imrie (2004: 745) explains this relationship:
A person’s mental and physical wellbeing is related to many circumstances, not the least of which is
the quality of their dwelling and home environment. An important part of such quality is physical
design and layout, and how far it enables the ease of people’s mobility and movement around the
dwelling and the use of different rooms and their facilities.
There is a growing crisis in Aboriginal communities, evidenced by high and multiple levels of disadvantage,
demonstrating the enormous disparities in the social determinants of Aboriginal healthhousing, education
and the availability of nutritional food, employment and health care. The Central Australian Aboriginal
Congress (2011: 2) has noted that:
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 8
Put simply, the social gradient in terms of housing, education, employment, access to justice and
empowerment are directly linked to the disastrous health outcomes we face. They are directly linked
alsoto the ongoing effects of substance abuse, family violence and child neglect and abuse. If
Aboriginal people are to achieve health outcomes equivalent to those of the broader Australian
population, people’s living conditions must be improved alongside access to health services (Southern
Public Health Unit Network 2003).
Access to housing for Indigenous peoples living with mental illness and/or
psychosocial disability
The Reform of the Federation White Paper Roles and Responsibilities in Housing and Homelessness
(Department of Prime Minister and Cabinet 2014) also makes salient points in regard to housing and disability,
notably:
…some groups—including Indigenous Australians, older people, young people, and people with mental
illness or disabilityare more likely than others to experience difficulty securing stable and affordable
housing. This is complicated when individuals face multiple disadvantages and interact with multiple
service systems (p.10).
For housing, disability and social supports it is noted that there are:
1. A lack of culturally- and disability-appropriate housing options and services (and other social services)
for Aboriginal people living with a disability.
2. Under-use of mainstream disability and other social support services (including disability-related
housing services) by Aboriginal people, generally.
3. Lack of awareness of disability-related housing needs (and available supports) among Aboriginal
people living with disability, their families and some service providers.
4. Negative experiences with housing agencies, impacting on people's desires to interact with them.
5. Some service providers expressing occupation, health, safety and welfare concerns entering into sub-
standard housing, impacting on the delivery of supports to some people.
6. Lack of Aboriginal specific accommodation services.
7. Desire for more Aboriginal-run services for people living with disabilities.
8. A high prevalence of sub-standard Aboriginal housing, especially in remote communities.
9. A high prevalence of housing and accommodation options that are physically inaccessible for
Aboriginal people living with disabilities and health related issues.
10. Issues of nepotism in Aboriginal housing.
11. Cultural inappropriateness of much public housing, with available stock insufficient in terms of
accessibility, size and number of bedrooms, and wet areas, as well as there being issues around
tenancies because of overcrowding, mobility and 'visiting', kinship traditions et cetera.
12. Poor understanding of rights and responsibilities among public (social) housing tenants.
13. Challenges around accessing support for modifications to properties (to make them more culturally-
appropriate), including in public (social) housing (Grant et al 2017).
For Aboriginal peoples accessing supported accommodation major issues arise in:
1. Highly limited uptake of supported accommodation options by Indigenous people living with
disabilities (although no clear data on this).
2. Concerns over the location of such facilities, away from communities, country, significant events.
3. Unmet need for services, with a possible appetite for Aboriginal-run services (these must be culturally
appropriate in terms of design, orientation, and operation, as well as being in appropriate locations).
4. Lack of support for 'group home' models of living (Grant et al. 2017).
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 9
There are very limited housing access and housing choices for Aboriginal people living with disabilities at every
level; across all types of disability, degrees of disability, regionally and nationally. The lack of disability-friendly
housing, culturally appropriate supported accommodation, disability services and transport in regional, rural
and remote areas means people are often forced to leave their communities in order to access services and
housing. Being “off Country” brings great distress to many people. Homelessness or imprisonment are often
the only housing options available for Aboriginal peoples living with mental illness and/or psychosocial
disability (Grant 2018: 2018b).
Housing design for Aboriginal peoples with mental illness and/or
psychosocial disability.
The NDIS recognises that providing housing that is first and foremost ‘a home’, as opposed to a workplace or
institution, is accepted as ‘best practice’ for all people with disability.
While there is a large body of knowledge on the cultural design of housing to meet Indigenous users’ socio-
spatial needs, domiciliary behaviours, cultural values and aspirations, universally this states there is no one
solution to providing and designing housing for Indigenous people and little knowledge on ‘best-practice’
housing design for Indigenous people living with a disability.
More general studies have shown the individual needs of non-Indigenous people living with disability are
diverse and require case-by-case housing responses.
Some research suggests that key housing attributes for people with mental illness or psychosocial disability
include security of tenure (stable housing), affordability and a suitable location. For example, it has been shown
that people with an acquired brain injury, mental illness or psychosocial disability, for example, may find it
difficult to maintain a residence or adequately meet the requirements of a tenancy.
1
At the same time very
little is known about the attributes for design of housing for Aboriginal peoples with mental illness and/or
psychosocial disability and the impacts of lack of housing or sub-standard housing on the individual, families
and communities (especially as seen in social issues such as homelessness, rough sleeping, family violence,
community dysfunction).
Summary and recommendations
The NDIS has been widely heralded as a watershed in the delivery of supports for people living with a disability;
a transformational opportunity for those eligible for services under the scheme and a way to strongly influence
governments, the community, mainstream and other specialist services to truly recognise and meet the needs
of some of the most vulnerable and excluded within the community.
The reality is that Indigenous people living with mental illness is that there are layers of disadvantage and
numerous barriers in terms of service access and delivery, with whole of life implications. In many instances,
even basic services are not available to support community living for Indigenous people living with mental
illness, let alone to let people thrive living with their families, communities and cultures. The end result is that
South Australia’s prisons hold many Aboriginal people living with complex health issues, mental illness and
psychosocial disability, drug and substance abuse issues, and unresolved trauma and grief.
1
The episodic nature of such disabilities often requires people with psychiatric and cognitive disabilities to spend periods of time in care meaning that
they may find it difficult to maintain a rental property. Inappropriate behaviour exhibited during psychiatric episodes may result in people being evicted
for property damage or in response to complaints by neighbours.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 10
Housing options for Indigenous people with mental illness and/or psychosocial disability are limited at every
level and fail the key social mandate of an inclusive and responsive society.
Ongoing reform of the disability support sector offers potential for issues around housing to be brought to the
policy fore. Continuing work in the area is imperative given the NDIS legislation and Australia’s obligations as
a signatory to the United Nations Convention on the Rights of Persons with Disabilities.
We recommend that the Social Development Committee consider the following:
1. A re-evaluation of the NDIS definition of indigenous psychosocial disability which includes cultural
factors, mental illness, complex health issues, including drug psychosis, and other comorbidities to
allow support services to be delivered within the framework of the NDIS.
2. An urgent response to the over incarceration of Aboriginal peoples living with mental illness and or
psychosocial disability be made. The response may include:
Urgent consideration to alternatives to imprisonment for Aboriginal peoples living with mental
illness and/or psychosocial disability.
Data be gathered on the numbers of people in the South Australian prisons with mental illness,
the services available to them and their conditions of confinement.
Data be gathered on the numbers of people with mental illness in the South Australian prisons
held as ‘unfit to plea.’
Timely and culturally appropriate mental health assessment and access NDIS assessment, package
and adequate supports for people in the criminal justice system.
3. An urgent response to Aboriginal people living with mental illness and/or psychosocial disability
experiencing homelessness, or rough sleeping due to a lack of housing options.
4. Evidence-based research into ‘best practice’ accommodation planning and design for housing and
supported accommodation for Aboriginal peoples living with mental illness and/or psychosocial
disability be completed.
5. The Government commit to delivering culturally appropriate housing and supported accommodation
to Aboriginal people living with mental illness and/or psychosocial disability.
Submission to the Parliament of South Australia Social Development Committee Inquiry into the provision of services for people with mental illness
and/or psychosocial disability under the transition to the National Disability Insurance Scheme (NDIS)
The University of Canberra 11
References
Australian Bureau of Statistics (2016), 4714.0 National Aboriginal and Torres Strait Islander Social Survey,
Australia, 201415, cat. no. 4714.0, ABS, Canberra.
Central Australian Aboriginal Congress (2011), Rebuilding family life in Alice Springs and Central Australia: the
social and community dimensions of change for our people, CAAC Paper,
www.caac.org.au/uploads/pdfs/Rebuilding-Families-Congress-Paper.pdf
Department of the Prime Minister and Cabinet [DPMC] (2014) Reform of the Federation White Paper: roles
and responsibilities in housing and homelessness, Issues Paper no. 2, DPMC, Canberra.
Grant, E. (2018). Conference Paper: Reconceptualising the Prison. Hāpaitia te Oranga Tangata Aotearoa New
Zealand National Criminal Justice Summit. 20-24th August 2018.
Grant, E. (2018a). Conference Paper: Indigenous People and Prisons: Taking trauma informed and health-
based approaches. Prisons 2018. August 2nd-3rd August 2018, Melbourne
Grant, E., Zillante, G., Srivastava, A., Tually, S. & Chong, A. (2017). Housing and Indigenous People living with
a disability: Lived experiences of housing and community infrastructure AHURI Final Report 283.
Melbourne: Australian Housing and Urban Research Institute.
Grant, E., Zillante, G., Tually, S., Chong, A., Srivastava, A., Beilby, J. & Beer, A. (2016). Housing and Indigenous
People living with a disability: Lived experiences of housing and community infrastructure, AHURI
Positioning Paper, Melbourne: Australian Housing and Urban Research Institute.
Imrie, R. (2004), Disability, embodiment and the meaning of the home, Housing Studies, vol. 19, no. 5: 745
763.
Southern Public Health Unit Network (2003), Social determinants of health fact sheet: Aboriginal and Torres
Strait Islander health, West Moreton Public Health Unit, Ipswich, Queensland Health,
https://www.health.qld.gov.au/ph/Documents/saphs/20400.pdf.
ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
While aspects of the home may provide for privacy, sanctuary, security and other aspects of ‘ideal’ domestic habitation, such provisions are always conditional, contingent, never secure and likely to be challenged by, amongst other things, the onset and development of bodily impairment. However, explorations of the meaning of the home, and housing studies more generally, rarely consider the body and impairment and its interactions with domestic space. This is curious because impairment is a significant, and intrinsic, condition of human existence and can affect anyone at any time. The paper develops the argument that a person's feelings about, and experiences of, the home cannot be dissociated from their corporeality or the organic matter and material of the body. Thus, the quality of domestic life, and housing quality more generally, has to be understood, in part, with reference to the body and conceptions of corporeality.
Rebuilding family life in Alice Springs and Central Australia: the social and community dimensions of change for our people, CAAC Paper, www.caac.org.au/uploads/pdfs/Rebuilding-Families-Congress-Paper.pdf Department of the Prime Minister and Cabinet
Central Australian Aboriginal Congress (2011), Rebuilding family life in Alice Springs and Central Australia: the social and community dimensions of change for our people, CAAC Paper, www.caac.org.au/uploads/pdfs/Rebuilding-Families-Congress-Paper.pdf Department of the Prime Minister and Cabinet [DPMC] (2014) Reform of the Federation White Paper: roles and responsibilities in housing and homelessness, Issues Paper no. 2, DPMC, Canberra.
Conference Paper: Reconceptualising the Prison. Hāpaitia te Oranga Tangata Aotearoa New Zealand National Criminal Justice Summit
  • E Grant
Grant, E. (2018). Conference Paper: Reconceptualising the Prison. Hāpaitia te Oranga Tangata Aotearoa New Zealand National Criminal Justice Summit. 20-24th August 2018.
Conference Paper: Indigenous People and Prisons: Taking trauma informed and healthbased approaches. Prisons
  • E Grant
Grant, E. (2018a). Conference Paper: Indigenous People and Prisons: Taking trauma informed and healthbased approaches. Prisons 2018. August 2nd-3rd August 2018, Melbourne