The Western Australia coroner has released the findings of an inquest into the deaths of thirteen children and young people in the Kimberley.

Coroner Ros Fogliani determined twelve of the thirteen deaths were by suicide and found “crushing poverty” and intergenerational trauma formed part of the broader circumstances around their deaths.

The coroner found appropriate intervention or mental health services had no contact with the young children at risk and that in many cases, extended family placements were not fully assessed for suitability, with some of the children at risk of ongoing harm.

In a statement, Kimberley Land Council CEO Nolan Hunter said the council welcomed the coroner’s recommendations in support of cultural healing, connection to country, and culturally centred and regionally-led solutions.

“While we are hopeful that today’s findings will be a line in the sand, we know this inquest follows many other reports, reviews and recommendations,” he said.

“We must focus on outcomes, rather than output, on collaboration, rather than separation, and a whole of community approach. This is a Kimberley issue that requires all Kimberley organisations to play a part in their respective fields.”

Regional body for the Kimberley, Aarnja, was supportive of the recommendation for Aboriginal self-determination.

Aarnja CEO Maureen O’Meara said the issues or challenges in any strategy, project or in any campaign were rarely one-dimensional or straightforward.

“We’ve seen millions of dollars thrown at programs in the Kimberley that are ostensibly set up to help our people. But families haven’t been consulted about the effectiveness of these programs on-the-ground—or consulted as to whether to programs are needed at all,” she said.

Ms O’Meara said the Westerman Aboriginal Symptom Checklist for Youth (WASC-Y), developed by Dr Tracy Westerman, was a valid assessment tool for Aboriginal kids at risk.

“If you get the assessment right, then the servicing, treatment and follow through is right. But despite the fact this tool has been around for 20 years, it’s never been implemented in the Kimberley,” she said.

Dr Tracy Westerman is a proud Njamal woman and a clinical psychologist. She’s recognised for spending over two decades working to reduce the burden of mental ill health and suicide in Aboriginal communities.

Dr Westerman is concerned at public commentary on the causes of suicide, and in an opinion piece for NIT she stated explicitly that suicide is not caused by poverty, abuse, alcohol of foetal alcohol syndrome.

“They are all very likely risk factors, but they are not CAUSES. We need to better understand this distinction. If we have clear evidence of the causes, this will ensure that programs are better focused on suicide reduction,” she wrote.

Dr Westerman noted that research amongst non-Aboriginal populations had depression as an established causal pathway to suicide in around 50% of cases.

“Research then further indicated that if we could eliminate depression from the suicide equation by determining treatments of best practice for depression, we can effectively reduce up to 50% of suicide deaths … See how important causal pathways are!”

However, limited evidence on Indigenous-specific suicide risk factors, meant there was no evidence to help establish causal pathways.

Ms O’Meara said that Kimberley Aboriginal people are eager to work together to address the gaps in the knowledge and to implement solutions that work.

“Kimberley Aboriginal people are ready to lead solutions, we have been for a long time, since we held a significant meeting at Crocodile Hole almost 30-years ago. It’s time for Kimberley Aboriginal people to be part of regional decision and policy-making,” Ms O’Meara said.

By Andrea Cantle