Paving the way for a new generation of Indigenous healthcare workers

Recent Monash graduate Dr Victoria Gentile is a perfect case study to show the rapid increase in the University’s Indigenous healthcare students, and also to show why more and more are needed.

Her mentor, Professor Karen Adams, says: “Victoria is an inspirational Yorta Yorta woman from the northern suburbs of Melbourne. She’s got this humble way about her. She doesn’t consider herself important because she has ‘Dr’ before her name. She’s just one of the mob. She has a really lovely way in the world.”

Professor Adams is the Director of Gukwonderuk, the Faculty of Medicine, Nursing and Health Sciences’ Indigenous engagement unit, and a Wiradjuri woman.

According to the latest numbers, only 44 Indigenous students were enrolled in the giant MNHS faculty in 2014. Nine years later there are 152, and growing.

Her fellow graduates came from the fields of surgery, occupational therapy, paramedicine, nursing, physiotherapy, nutrition sciences, mental health, and reproductive science.

Dr Gentile studied psychology and now works with addiction. Her PhD theses researched the portrayal of Indigenous Australians in government publications, and the effect of racism and colonisation on wellbeing.

Her mother has worked in Indigenous social justice and community welfare in Melbourne. Professor Adams is “Aunty Karen” to her.

The research she did for her theses was hard, and “the results for me were quite shocking,” she says.

“There were a lot of experiences of racism in places that I wouldn't necessarily expect. I think a lot of Australians are firmly on the side of thinking there's not that much racism in Australia any more. This is a reminder that, yes, there is, and we need to do something about it.”

One thesis was picked up and amplified by the peak body, the National Aboriginal Community Controlled Health Organisation (NACCHO). “Victoria is influencing policy at a national level,” Professor Adams says.

Read more: Mental health and wellbeing: Listening to young Indigenous people in Narrm

Dr Gentile’s work now is at the frontline.

“I’m a psychologist doing drug and alcohol counselling with offenders that have just been released, and high-risk offenders, to help them with their substance use and everything that comes along with it, to help reduce offending,” she says.

“I also run drug and alcohol programs about specific drugs, how to manage cravings, how to cope with emotions in more adaptive ways rather than using. We also look at criminogenic thinking, and how that ties in with substance use.

“A lot of these people have been living this way for a very long time; they’ve grown up this way. So for a lot of them, it’s almost like they can’t imagine what it would be like to be normal, or to not use substances.

“It’s not even on their radar, and they just have so many complicated issues that really compound that – a lot of domestic violence, a lot of interpersonal difficulties, a lot of shame and guilt, and a lot of trauma,” she says.

“The work is about helping them work through that, and trying to get to the point where they can actually see a life outside of substance use and feel like they can cope with all the other stuff without it.”

High interest in mental health

Dr Gentile is the first Indigenous clinical psychologist to graduate from Monash. The most popular streams for Indigenous students in MNHS are nursing and midwifery, medicine, and increasingly, psychology.

“In general, there’s a lot of interest in mental health, and social and emotional wellbeing,” says Professor Adams, “because Indigenous people can experience quite a lot of trauma from inequity. I think Indigenous students want to make a difference, so gravitate to that area.”

She says Gukwonderuk worked specifically on clinical psychology to boost numbers.

“We worked with the School of Psychology to go through a process of having more equitable Indigenous student selection into the clinical psychology PhD, which from the head of school down they took on.

“We look for student success factors to study the course. This helps to address a long legacy of inequity and an underrepresentation of Indigenous people in psychology.”

With the William Cooper Institute there’s now structures in place for engaging Indigenous students navigating the University’s academic framework, logistics, administration, scholarships and bursaries – including bursaries to travel away from Melbourne for “sorry” business, and for expenses relating to accommodation and workplace costs.

Gukwonderuk also assists students in attending Indigenous professional networking events such as the Australian Indigenous Doctors Association, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, and Indigenous Allied Health Australia.

“The students go,” Professor Adams says, “they meet peers, and they develop an identity as both an Indigenous person and a health professional, which I think is important.

“We have a mentoring program as well, where we introduce an older student or someone in the higher years to first-year students. It’s called the Kirrip Program, Kirrip is Woiwurrung for ‘friend’.”

Dr Gentile, she says, was shocked when she was first made an offer for a PhD place, but became an important person in Gukwonderuk networks.

“She has an amazingly critical mind. She doesn’t just accept things that happen are the way they should be. She questions. She has deep insights into how certain things in clinical psychology could be problematic for some people, and that there might be another way of approaching things that would be more useful.

“But she was also teaching others a lot as well. Because of her maturity and mind, she was able to grapple with it all. And she worked all through her PhD as well, at Woolies.”

Read more: Lines of communication: How Indigenous knowledge can improve the memory

Indigenous professionals in healthcare of any kind can make a huge difference on the ground, where problems are real and raw, and people need help and understanding.

“Victoria is the perfect example,” says Professor Adams. “I imagine Indigenous people would feel much safer with an Indigenous psychologist. She would already know the cultural nuances, and she has a relational responsibility to the community.

“Aboriginal healthcare workers make a positive difference for everybody in healthcare, because Aboriginal healthcare workers often just operate in a relational paradigm, or a way of thinking. You feel more responsibility for people, you care for people more deeply.”