Acknowledging the Stolen generations

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) pays its respects to individuals of the Stolen Generation and to their families and communities across Australia. The RANZCP recognises the importance of continuing to acknowledge the devastating impacts of the forced removal of Aboriginal and Torres Strait Islander children from their families. In April 1999, the RANZCP made a formal apology to Aboriginal and Torres Strait Islander peoples, for its failure as a group of doctors and psychiatrists to act early and effectively to try and prevent and reverse these disastrous practices.[1] The RANZCP continues to affirm the importance of psychiatrists practicing in a manner that supports reconciliation, and reflects the principles of trauma-informed practice. 

Key messages

• The RANZCP apologises for the role played by psychiatrists in harms to Aboriginal and Torres Strait Islander communities arising from forced child removal practices and commits to taking action to prevent these practices from occurring again.
• The RANZCP affirms the importance of acknowledging the destructive policies that allowed the Stolen Generations, and for psychiatrists to practice in a manner that is sensitive to its impacts upon individuals. 
• The Stolen Generations have inflicted deep harm on Aboriginal and Torres Strait Islander people, requiring the rebuilding of trust between government authorities, psychiatrists and communities. 
• Government policies and practices of child removal have an intergenerational impact on the health and social wellbeing of Aboriginal and Torres Strait Islander communities and families.
• Ongoing reform to legislation and practice is still required as inappropriate removal of Aboriginal and Torres Strait Islander children continues, and the application of the Child Placement Principle remains inconsistent across jurisdictions.
• The RANZCP is committed to ensuring that principles of cultural competency are reflected throughout our education and training program.

Evidence

It is now over two decades since the publication of the Australian Human Rights Commission (AHRC) Report, The National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children and Their Families: Bringing Them Home Report (1997).[2] The Bringing them Home Report was an investigation into governmental policies of forced removal of Aboriginal and Torres Strait Islander children from their families. The consequences of these policies continue to profoundly impact the health and social wellbeing of Aboriginal and Torres Strait Islander peoples.[3] Since the release of the report successive reviews into governmental responses have been consistently critical of the poor implementation of recommendations made with reference to under-funding of Aboriginal health and wellbeing programs, poor coordination or services and lack of progress on Aboriginal and Torres Strait Islander recognition and self-determination.[4]  

The Bringing them Home Report documented terrible abuses. Generations of Aboriginal and Torres Strait Islander communities faced the terror and grief of having children taken from them. Thousands of Aboriginal and Torres Strait Islander children suffered severe psychological injury through being deprived of their parents, community, country and culture; confined to institutions they were beaten, sexually abused and exploited. Some children may have been killed; others took their own lives. Children were lied to and told that their parents or siblings were dead. Parents were told that their children were dead. 

The removal of Aboriginal and Torres Strait Islander children from their families was often justified with the paternalistic aims of ‘providing’ them with opportunities, such as education. This was often done in a coercive or damaging manner, with parents being made to sign forms they did not understand. Siblings were often separated during the process of removal and placement in care and contact with natural family disallowed. In other instances claims of neglect were used as justification for the removal of children; these claims tended to be unfounded and insignificant compared with the neglect the children experienced following removal, as the following excerpt from evidence given by a woman removed at nine years of age in the 1950s demonstrates:

And for them to say she [mother] neglected us! I was neglected when I was in this government joint down here. I didn’t end up 15 days in a hospital bed [with bronchitis] when I was with me mum and dad.[2]

A common theme that spans accounts of Aboriginal and Torres Strait Islander people who were removed as children is the trauma of separation from their attachment figures, the confusion of having culture and identity denied and negatively characterised, and grief at the abuse experienced in foster homes and institutions. There was also the more sinister motivation of assimilating Aboriginal and Torres Strait Islander cultures into white culture, leading to the ‘dying out’ of traditional cultures, languages and ways of life. When children were separated from their families and communities, they were forbidden to speak their languages or practice traditional beliefs or customs. They were taught that Aboriginal and Torres Strait Islander cultures were inherently inferior, as the following statement from a woman fostered at 10 years of age in the 1960s describes:

All the teachings that we received from our [foster] family when we were little, that black people were bad… I wanted my skin to be white.[2]

Part of the reason these practices could continue for so long was due to the systematic racism that was underpinned by government policies of exclusion and segregation. These feelings were amplified by society’s collective approach to Aboriginal and Torres Strait Islander people that included denial of existence, denial of Native Title, race-related discriminatory policies, and a lack of recognition of Aboriginal and Torres Strait Islander peoples. This discrimination extended to the Australian Constitution and other laws across Australia that did not include Aboriginal and Torres Strait Islander peoples; See RANZCP Position Statement 68: Recognition of Aboriginal and Torres Strait Islander peoples in the Australian Constitution.

Effects on mental health 

Psychiatrists have a professional, moral and social obligation to comment on social practices and policies which are harmful to mental health. The RANZCP acknowledges that many psychiatrists were complicit in the suffering caused by the removal of Aboriginal and Torres Strait Islander children from their families and that in some cases the medical profession was involved in the planning and implementation of these policies.[2] It is therefore essential that psychiatrists working with communities assess and treat individuals with an empathetic understanding of the range of historical and contemporary issues which affect Aboriginal and Torres Strait Islander people. Aboriginal people will experience specific mental health challenges associated with removal, including severe personal emotional distress, anxiety and depression, PTSD, and cumulative distress owing to disconnection from country and community, which is increasingly being recognised as a form of solastalgia.[5, 6]

The Bringing them Home Report, highlighted the ‘entrenched disadvantage and dispossession’ that has contributed to the continued removal of Aboriginal and Torres Strait Islander children today. Aboriginal and Torres Strait Islander children are ten times more likely to be in out-of-home care than non-Indigenous children, with rates as high as eighteen times more likely in some states.[7] The ongoing mental health impacts of the Stolen Generations are described in the Overcoming Indigenous Disadvantage Report (OID Report) released by the Productivity Commission in November 2014 and updated in 2016.[8] The OID Report reflects improvements in many areas, however, mental health, suicide rates and self-harm indicators are all shown to be deteriorating. 

Experience of racism and the impact of family separation are identified in the OID Report as key risk factors leading to these ongoing issues. In 2019 Australian Institute of Health and Wellbeing (AIHW) Report Children living in households with members of the Stolen Generations, indicates that children living with a member of the Stolen Generations, have an increased likelihood of adverse outcomes and a transfer of intergenerational poverty and trauma.[9] Aboriginal and Torres Strait Islander children who have involvement with Child Protection are more likely to experience long term social disadvantage and over-representation in juvenile justice and adult criminal justice systems. 

The policies that underpinned the Stolen Generations, along with other discriminatory policies and practices, have profoundly contributed to the poorer health status of Aboriginal and Torres Strait Islander populations to this day. The Aboriginal and Torres Strait Islander Child Placement Principle (the Principle) was developed to ensure culture is understood as being integral to the safety and wellbeing of Aboriginal and Torres Strait Islander children; increase the level of self-determination of Aboriginal and Torres Strait Islander peoples in child welfare matters; and to reduce the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care. [10] While significant work has been undertaken across jurisdictions to strengthen implementation of the Principle, adherence remains poor.[11]

The psychological trauma caused by forced removals of children has life-long, community and intergenerational mental health consequences. See RANZCP Position Statement 100: Trauma-informed Practice. The mental health implications of these experiences are starkly illustrated in the following account recorded in the Bringing them Home Report:

It never goes away. Just ‘cause we’re not walking around on crutches or with bandages or plasters on our legs and arms, doesn’t mean we’re not hurting. Just ‘cause you can’t see it doesn’t mean…I suspect I’ll carry these sorts of wounds ‘til the day I die. I’d just like it to be not quite as intense, that’s all.[2] 

Recommendations

The RANZCP commits to the following action to prevent the practices of the Stolen Generations from occurring again: 

• Strengthen cultural competency among psychiatrists and trainees that supports practice which respects Aboriginal and Torres Strait Islander values, culture and history; including an understanding of the history of the Stolen Generations and its ongoing impacts.
• Acknowledge the need for continued vigilance and scrutiny of current and future policy which may impact adversely on the health and welfare of Aboriginal and Torres Strait Islander peoples and advocate against such changes.
• Continue support for reconciliation and self-determination initiatives such as the Uluru Statement from the Heart as an acknowledgement of collective healing and an encouragement for governments to ensure Aboriginal and Torres Strait Islander leadership in policies that impact their communities. 
• Support those policies and programs promoted by Aboriginal and Torres Strait Islander peoples as strengthening, empowering and healing initiatives. Such as the AIATSIS Family History and Link Up(s) or similar services across jurisdictions.[12]
• Through position statement development, educational initiatives and congress symposia, support psychiatrists and trainees to develop a full understanding of the role of complex trauma in Aboriginal and Torres Strait Islander presentations.

The RANZCP recommends that psychiatrists and trainees also incorporate the following into their practice:

• Recognise that past practices of state sanctioned removal of Aboriginal and Torres Strait Islander children from their parents, community, country and culture were cruel and harmful.
• Apologise to Aboriginal and Torres Strait Islander peoples for the failure of the psychiatric profession to intervene in these devastating practices and for any complicity in their implementation.
• Support Aboriginal and Torres Strait Islander peoples to control and deliver programs and services for their own communities and individuals
• Commit to practices which respect the importance of culture, family and kinship for Aboriginal and Torres Strait Islander children.
• Develop awareness of the impact of the Stolen Generations and the repercussions that continue to the present day. This includes being mindful of the impact of dislocation from land, family, culture and community on Aboriginal and Torres Strait Islander peoples both in the past and in the present. Care and creativity should be applied in working around these issues to avoid replicating past trauma.

Responsible committee: Aboriginal and Torres Strait Islander Mental Health Committee

References

1.    Royal Australian and New Zealand College of Psychiatrists. Position Statement 42 - Stolen Generations - RANZCP Apology for the role played by psychiatrists in the Stolen Generations. Melbourne. April 1999.
2.    Human Rights and Equal Opportunity Commission. Bringing Them Home : Report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from Their Families. 1997.
3.    Commission for Children and Young People. ‘Always was, always will be Koori children’: Systemic inquiry into services provided to Aboriginal children and young people in out-ofhome care in Victoria. Melbourne: Commission for Children and Young People; 2016.; 2016.
4.    Aboriginal and Torres Strait Islander Healing Foundation. Bringing Them Home 20 years on: an action plan for healing. 2018.
5.    Albrecht G, Sartore G-M, Connor L, Higginbotham N, Freeman S, Kelly B, et al. Solastalgia: The Distress Caused by Environmental Change. Australasian Psychiatry. 2007;15(1_suppl):S95-S8.
6.    Kingsley J, Townsend M, Henderson-Wilson C, Bolam B. Developing an Exploratory Framework Linking Australian Aboriginal Peoples’ Connection to Country and Concepts of Wellbeing. International Journal of Environmental Research and Public Health. 2013;10(2):678-98.
7.    Productivity Commission. Report on Government Services 2019. Melbourne; 2019.
8.    Productivity Commission. Overcoming Indigenous Disadvantage: Key Indicators 2016. 2016.
9.    Australian Institute of Health and Wellbeing. Children living in households with members of the Stolen Generations, Table of contents - Australian Institute of Health and Welfare. 2019 11 June 2019.
10.    Australian Institute of Family Studies. Enhancing the implementation of the Aboriginal and Torres Strait Islander Child Placement Principle: Policy and practice considerations. 2015.
11.    SNAICC - National Voice for our children. Reviewing implementation of the Aboriginal and Torres Strait Islander Child Placement Principle. 2019.
12.    Australian Institute of Aboriginal and Torres Strait Islander Studies. Stolen Generations. 2018. 

Disclaimer: This information is intended to provide general guidance to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances, information or material that may have become subsequently available.