1. Gay Foster Project Manager, MH-Kids Mental Health and Drug & Alcohol Office Elizabeth Best Manager, Priority Populations NSW Kids & Families August 2013 ‘Strong Women Strong Babies’ Improving Outcomes Through Additional Mental Health and Drug & Alcohol Support

2. Aboriginal Health Indicators

3. Aboriginal Pregnant Women: Substance Use and Mental Health in NSW Substance use during pregnancy (2013)  Tobacco 47.1%  Alcohol 17.4%  Other Substances 3.9% Smoking during pregnancy (2012)  Decreased from 59% in 2001 to 48% in 2010 Aboriginal and Torres Strait Islander women are at higher risk of mental health problems..........

4. Fetal Alcohol Spectrum Disorders Alcohol can alter the normal development of the fetus. The possible effects of fetal alcohol exposure include brain damage, birth defects, poor growth before and after birth, low IQ or learning difficulties, delayed development, social and behavioural problems and problems with hearing, speech and vision. 1. ‘ No alcohol during pregnancy is the safest option ’.

5. Aboriginal Maternal & Infant Health Service (AMIHS) Principles: Broad and social view of health Effective partnerships Primary health care Cultural respect and competence Community development

6. AMIHS Essential Elements Antenatal and postnatal care up to 8 weeks Community development and health promotion Workforce development and lifelong learning Working collaboratively with local Aboriginal Community Controlled Health Services Seamless transition to child and family health services – Building Strong Foundations (BSF) Evaluation and monitoring Effective collaboration including consultation and referral - Brighter Futures

7. Achievements Decrease in prematurity rates Decrease in perinatal mortality not statistically significant Increase in access to antenatal care Increase in breastfeeding initiation to 6 weeks High satisfaction by Aboriginal women

8. Where the Journey Began..... Closing The Gap Healthy strong babies Early childhood education Completing school Health Employment Living standards Life expectancy

9. 8 Indigenous Early Childhood Development National Partnership Element One – Integration of early childhood services through Children and Family Centres Element Two – Increased access to antenatal care, pre-pregnancy and teenage sexual and reproductive health Element Three - Increased access to, and use of, maternal and child health services by Indigenous families

10. MHDAS Partnerships Access Culturally safe Prevention and early intervention Community engagement Community development Workforce

11. IECD NP E2 AMIHS/MHDAS Locations

12. State-wide Governance, Accountability and Support Implementation Plan - Ministerial approval 6 monthly reports against milestones to Commonwealth Implementation/working groups Data development Evaluation Working agreement paper Training and support unit Resources Social marketing campaigns

13. ‘Stay Strong and Healthy – It’s Worth It’ (Aboriginal Prenatal Mental Health and Drug and Alcohol Campaign) ‘It’s Your Choice Have A Voice’ (Aboriginal Health and Medical Research Council) Social Marketing Campaigns

14. ‘Stay Strong and Healthy - It’s Worth It!’ Launched in July 2012 with:  Radio and print advertising  Illustrated story book  Indigenous and local media  Posters & Postcards  Facebook https://www.facebook.com/StayStrongAndHealthy http://www.yourroom.com.au/Resources/stay-strong-and-healthy- posters.html

15. ‘Stay Strong and Healthy – It's Worth It’ Resources

16. It’s Your Choice Have A Voice WALGETT NSW Aboriginal children singing and Dancing about Rights, Respect and Responsibility

17. Local Governance and Accountability Management Steering Group including MHDAS and AMIHS managers Development of :  Implementation plans  Models of care  Memorandum of Understanding/Service Level Agreement  Cultural and clinical supervision plans Data collection Quarterly reporting

18. Partnerships Commonwealth and State  Commonwealth agencies  State agencies  Aboriginal Health and Medical Research Council Local  Maternity, mental health and drug and alcohol and Aboriginal health services  Aboriginal Community Controlled Health Services  Aboriginal Communities

19. Partnerships with Local Aboriginal Communities

20. MHDAS Evaluation (2013-2014) Evaluation will:- Assess the Initiative’s achievements against Commonwealth’s milestones Assess the extent to which the model has been effective in achieving aims of the AMIHS/MHDAS initiative Make recommendations for future directions of the AMIHS/MHDAS initiative

21. LEARNINGS Partnerships Culturally safe Integrating mental health drug & alcohol services with primary health care reduces stigma Community based services provide a ‘soft entry’ ‘One stop shop’ approach encourages attendance Co-location of workforce is beneficial to families Social media – a successful strategy

22. Photo Acknowledgements: National Library of Australia nla.pic-vn4463084-v F0020173 Iconotec Stock Photography Royalty Free Photograph; http://ozoutback.com.au/Australia/abchna/index.htmlhttp://ozoutback.com.au/Australia/abchna/index.html Maternity Services Unit/ Maternity, Children and Young People's Health Branch/NSW Department of Health. GenerationOne. Questions Gay Foster Elizabeth Best Project Manager Manager MH-Kids Priority Populations MHDAO NSW Health NSW Kids & Families (02) 9816 0472 0408 573 230 (02)9391 9543 gfost@doh.health.nsw.gov.augfost@doh.health.nsw.gov.au ebest@doh.health.gov.auebest@doh.health.gov.au