in Conversation Dr Caroline Alcorso

Podcast Transcript

In Conversation with Dr Caroline Alcorso

March 2021

Scotia: Welcome back to Creative Responders and our first podcast for 2021.

I hope you’ve all had an opportunity to listen to Season 2 of our documentary series over the Summer – we’ve loved hearing your feedback on it, it’s great to know that these stories are having an impact on the way you think about and approach creative recovery.

From the Arbour Festival in the Snowy Valleys to bushfire recovery in the Gippsland region, First Nations artists and storytellers in North Queensland and the incredible teams at Wilurarra Creative and Community Arts Network in WA – it’s been a real privilege for us to share these stories with you.

We are back now to our monthly Conversation series where each month, we feature a conversation with one guest – bringing perspectives from a range of people working in the arts and emergency management space.

Kicking off our first episode for the year, I’m speaking with Doctor Caroline Alcorso who is currently directing the Natural Disaster Framework and Response for the National Mental Health Commission.

The development of this Framework is funded by the Australian Government in a bid to address the increasingly complex mental health needs of individuals and communities affected by natural disasters.

The aim of the Framework is to improve cross-government responses to mental health threats before, during and after natural disasters and it will be released in June this year.

Many of us are working on the frontlines in communities at a local level – and many of the stories we share on the podcast are about this grassroots community response and the one-on-one interactions around disaster preparedness and recovery.

We wanted to take a moment to pull back and look at the bigger picture to see what is happening nationally around mental health and wellbeing in relationship to disasters.

How is the response to our new reality of cascading impacts being approached at a national level and how does that approach incorporate the presence of the arts?

We know that the arts are a crucial component in strengthening social ties and building community resilience – essential ingredients for mental health and wellbeing.

So as we plan into the future of increasingly layered impacts of disaster, is there a shift occurring in terms of leaders and thinkers investing in alternative modes of engagement?

Caroline is based in Sydney and joined me over the phone to dive in to some of these questions.

Please enjoy my conversation with Doctor Caroline Alcorso.

Scotia: Welcome, Caroline. I’m calling in from Jagera Turrbal country here in Meanjin, Brisbane. Pretty misty, rainy day here today. So it’s very delicious. Where are you calling from?

Caroline: I’m on Eora country, the Eora land of the Gadigal people in Sydney, and it’s very hot, hot, clear, sunny. Yeah, but we have had lots of beautiful rain.

Scotia: Yeah. It’s so much of this watching the parched land drink it in here but everything is very green. So it’s encouraging for at least the rest of the year and a bit of a rest in the fire season. So Caroline, before we talk much about your role with the natural disaster recovery framework and response, can we ask a little about you and who who you are and what your work has been and what’s kind of led you to this point in your life?

Caroline: Well, you know, my life isn’t, I suppose I’m not one of those people who has a very clear and planned career trajectory so I do end up doing lots of different things.

I am from Tasmania and I guess my first memory of of disasters, and again it was fires, was the 1967 Tasmanian bushfires where we we were driving through flames on the major highway from north to south. And there were many, many people I knew who had to evacuate and who came to school wearing clothes that people had given them and so on.

And that and also it irrevocably changed a lot of the landscape near where I lived, turning it from what had been rainforest into sort of dry sort of semi sclerophyll forest after that all cleared altogether.

But I have worked a lot in community development. I’ve worked for government in policy and strategy. And my main focus is theme throughout my work has actually been workforce and workforce issues, the world of work but I’ve also had a sort of secondary, I suppose, specialization in health and I developed something called the National non-English speaking background Women’s Health Strategy back way back in the 90s.

And I’ve worked on other sort of major health initiatives since then and and ended up here. I was doing some work actually on health workforce with the Commonwealth Department of Health a couple of years ago. And sort of this that move transformed into this project with the National Mental Health Commission, which does have a strong workforce focus because the professionalisation of the recovery workforce is an issue certainly for the framework, but of course, it’s much more.

Scotia: Can you tell us a little bit about what that what the job is that you’re doing with the framework?

Caroline: Yeah. So at the time of the summer fires, as is often the case, you know, a lot of different organisations and governments kind of scramble to offer assistance. And the federal government has been playing a larger role in disasters for some time. And obviously we are having more disasters and they’re becoming more intense.

So the the Department of Health, well, there was there was a cross government, across the Commonwealth government, there was a national bushfire strategy and package funding package immediately in response in January 2020, and that involved funding for this framework.

So it involved a lot of other things, obviously, for local economic recovery and for health services and mental health services in particular. But it also, there was also a recognition right at that early stage, by Minister Hunt, that coordination and consistency and having some common language and framework for recovery is a key issue.

You know, even before things had kind of cranked up and started started being rolled out. It’s an issue that’s come up, of course, many times before in other disasters. So there was money allocated at that time for this National Disaster Mental Health Framework.

And the commission was asked to develop that document and have had a year to do it. So from June to June this year, which is when the framework is being delivered to government.

Scotia: Yeah, it’s interesting, isn’t it, that notion of communication and how it becomes the binding, but also the the fragility of systems that we work in and how we always struggle to try and find a way of greater transparency or greater ways of how we communicate across a common language.

But, you know, even just the word ‘recovery’ is so broadly used, you know, how do we how do we you know, how do we frame ways of being able to have a collective language that everyone is going to be able to agree on?

Caroline: That’s right. And we we’ve actually made the decision in the framework not to use the word recovery very often. Like, obviously, you can use lots of different words at different times, but we’ve kind of tended to just go with a very simple periodisation for the mental health framework, which is really just – before, during and after and ongoing – those as the phases, because recovery means so many different things.

We don’t at all want to give the impression that it’s some endpoint or goal that everyone will be aiming for and reach at a certain point because that isn’t consistent with people’s experiences.

So we’re just using that sort of before, after, before, during and after – and then some stakeholders we have been working with have suggested ‘after and ongoing’ makes more sense to them because the word after has that final…

Scotia: Because there’s no line in the sand, is there. Both individually and collectively. It’s very hard to define that.

So the scope of this framework obviously is involving involving a whole raft of individuals and stakeholders as emergency management does – it has such a mixed collection of different and diverse sectors of our community. How did you approach that process of consulting and bringing in those multiple partners into this development?

Caroline: Look, we really just used – we were lucky, I would say, in the first place that there were many inquiries and of course, the Royal Commission into National Natural Disaster Arrangements being taking place during 2020.

So we used and read a lot of the submissions that organisations had made to the those commissions and inquiries and a lot of very useful material came out of those. So we didn’t have to kind of completely rely on our own new consultations, but we have consulted with about, well, I don’t know, something like 115 organisations.

And we also one of the things we noticed very early on was that there seemed to be this real disconnect, which which government a lot of government staff spoke about just between what governments feel like they’re doing, which is rolling out a lot of new services, new new money, new new assistance, and what people seem to be experiencing on the ground, which was often – nothing’s happening, we’re not getting help, you know, things are chaotic, et cetera.

So we we thought we’d just with the limited funds we had available, we’d just engage community researchers in a few places for sites, as it turned out, in Queensland and in New South Wales to collect some stories and really detailed personal stories from people about their experiences following a disaster. So in the case of Queensland, it was the monsoon flooding, so it was earlier on it was a couple of years ago now.

And also all of these recent disasters are often accompanied by other disasters. So drought as well in Queensland and in New South Wales.

Scotia: That’s something that’s a very big part of what we’re looking at, isn’t it, this cascading impact? We haven’t really been shown to be very prepared for the multiple layers of what that means for people

Caroline: No. Very, very complex and challenging, I would say.

So that that has proved very useful because we did that quickly. So it was a bit of a sort of quick and dirty job of just like interviewing people and really trying to analyse

We asked University of Melbourne to then help us analyse that research. And it it did prove incredibly interesting because it and it’s not the first mental health disaster, mental health research to do this but it did it has shown the light very clearly on the aftermath issues.

So there’s mental health impacts of the disaster itself. But then there’s the aftermath and everything that happens after the disaster and how that can itself be traumatising, upsetting, anxiety producing, very frustrating, almost as bad as the initial disaster.

Scotia: Yeah. And we know that the underlying issues that were prevalent previously will be exacerbated again in these kind of vulnerable spots.

Caroline: Absolutely.

But we also heard from people who, you know, who really just focused in on the help seeking process and how difficult that was and how they would end up going to 17, 20 different places or calling and not really knowing they were themselves looking for a particular service. They were just looking for help. And it was difficult. You know, a lot of people get given long lists of services or websites.

And, of course, many people are not able to access websites easily following disasters or in rural areas as a whole. And and yeah just how, you know, the whole process of trying to fill in forms and then it being very dispiriting to find out how difficult it was and then not having the right documents and then suddenly the eligibility period had expired and all that kind of stuff that had a really sort of profound cumulative impact on people and made them feel stupid or really dispirited or just alienated and angry..

Scotia: Mmm, and left behind.

I mean, you in this work, you know, there’s a lot of talk about the challenges in this space, but also, you know, the term ‘post-traumatic growth’ has been being used much more now around this idea of positive outcomes for people and people’s lives. Did you sort of touch on that as well with your research or.

Caroline: No, not not much of that came out, but of course, it was just, you know, just a small group of people in each place. That and very much a self selected sample. But, yeah, obviously, I’m sure that, you know, there are many people who make a fresh start. I know most most disaster locations, people, a proportion of the population has moved away, and then there’s also the possibility of new social strong connections starting in places that have experienced disasters. And I think we’ve seen quite a lot of that in the Victorian case.

Scotia: It would be great to think that a framework would be there to support and grow, grow that more effectively into the future?

Caroline: Yeah, I mean, the framework will be it won’t I mean, it won’t be like a sort of manual. There are firstly, there are quite a lot of those already.

Scotia: Too many maybe.

Caroline: And secondly, it can’t be that because, you know, disasters are I mean, the response to disasters is very varied across Australia and it is primarily in the hands of the states state governments.

So, you know, it’s not really going to be possible for us to say to every state, you need to do this or exactly follow these steps. It won’t be that kind of thing.

It’ll be more principles, what to watch for, what not to do, simple kind of guidelines. But then need to be worked through at a state level.

Scotia: And if we’re looking at this sort of increasing layers of disasters that you mentioned earlier and the idea of so many multiple partners coming in to support communities in this space, what where do you see a framework like this opening up opportunities for more diverse ways of engaging around psychosocial wellbeing or community connection, which I’m assuming is a kind of main basis around mental health and wellbeing framework or objective?

Caroline: Well, I think I mean, I think the the bushfire recovery package from 2020, I mean, it was already a good start in that respect.

A lot of money from that package went into and from the subsequent packages went into community mental health and wellbeing grants or support at the grass roots kind of level rather than medical services. There was also a lot of money put into medical services and free medicare sessions and so on.

And quite a lot of that has not been taken up. And that’s in part that’s a question of ‘yet’ because, you know, certainly everyone’s very aware that it’s a long period in which such services may be called on.

But what was received very well was local community funding for different activities. And some primary health networks have already shown very innovative ways of rolling that money out of engaging large communities or different small communities in different parts of their region in co-design processes and doing that very well.

So I think there’s already a lot of developing practice in the area. And as I said, a recognition that it’s it’s community capital, community connections and helping communities rebuild that is really important.

Scotia: Well, it is that collaboration, isn’t it, that if you’re if you’re engaging people around things where there’s a kind of willingness to attend or participate because it’s a safe entry point, that then to connect that in with the mental health services or workers that can build a relationship towards more, more individualized support then that is always such a Win-Win isn’t it.

Caroline: Yeah, but it’s always bearing in mind that it’s really only ever going to be a small percentage probably that need more specialised services that the vast majority, it’s more about generalised kind of just psychological first aid support for, for children perhaps.

You know, different particular groups are more vulnerable and might need more and more kind of wellbeing, style services and support.

But I think the biggest threat is probably just to have funding. So much funding is short term, you know.

So I think you get a lot of people I mean, in some regions in New South Wales, there are, you know, five or even seven in some kind of recovery co-ordinator people for people in a region who are doing some kind of community development / liaison / engagement / network building, but so many you know, and then then many of them, the funding will cease and the people who have developed those really valuable skills and networks will continue. And the next lot of people will start again next time there’s a disaster.

And I think, of course, we have now a new federal government agency being stood up, which is the National Resilience Recovery and Relief Agency, so that certainly promises to be, to provide a more kind of constant and ongoing set of services, so that’s a really good thing.

Scotia: Yeah, so it’s that endless issue of of knowledge being lost in the cycle of it all. Yes, very frustrating.

Well, I suppose we see culture and the arts as a primary space and a primary tool for opening up safe spaces and to co-collaborate, as we talked about earlier, with wellbeing organisations and community organisations that are very localised level as well as a structural level.

And what, do you have any sense from your own world about the role that culture in the arts could potentially play or does play that you’re that you’re seeing through your own practice?

Caroline: I suppose through our own work, we’ve seen a lot of the initiatives that have been established for children and they seem to be highly successful and really fantastic.

I mean, there are quite a lot of different examples of of arts projects and of history, local history, local disaster preparedness style projects that involve the arts, storytelling videos, making videos and, you know, different cultural kind of styles, performance, etc..

So I think there’s a lot of great examples again and also that are well documented there are, of course, many on your own website. There are some on the Australian Institute for Disaster Resilience website as well.

And there was extra funding again nationally for schools for this kind of initiative. So, yeah, I think I think the arts, you know, it’s quite everyone, you know, I think does recognize the importance of the role of the arts in bringing people together and helping people therapeutically with a really traumatic situation.

So I suppose we’ll I mean, we’ll really just be emphasizing that in the framework, providing some examples and there will be a special background document on children and young people.

Scotia: Great. And in your in your process, what has been the engagement around First Nations knowledge? We know certainly from a cultural perspective the value and importance of leading with the kind of knowledge that they have around response and recovery and survival – what’s been the process of looking at that lens on this,

Caroline: We’ve we’ve engaged a lot through NACCHO, the National Association of Aboriginal Community Health Organizations – and we have a representative from Gippsland and East Gippsland Aboriginal Cooperative on our expert advisory group. We also have a representative of the National Indigenous Agency on our steering committee so we’ve we’ve we’ve got some input there. And again, we will be, of course, talking about their role, specific issues for Aboriginal people, quite you know, quite prominently in the framework.

Scotia: I think that became a very large part of our conversation in this 2020 fire season, became a very strong part of that national dialog.

Caroline: Yeah, particularly. I mean, the thing that has come through to us, apart from the the fire issues and, you know, cultural burning and different responses and preparation that is needed in Australia is also just the specificity of services that people, many indigenous people don’t necessarily feel comfortable going to all of the mainstream services often funded.

It’s far more effective to fund services that are local and that people trust and have confidence in. So that’s another really strong thing.

Scotia: And so after the framework has been released, what’s next for you? Do you know where you head from here?

Caroline: No, I don’t exactly know. But I’ve got quite a few other things that I do as well.

So I’m looking forward to having probably a bit of less frenetic time. But I’m sure there will be some follow up work from the framework as well, because we’ll be wanting to talk about the framework and communicate, you know, its its key lessons.

Scotia: It’s so important because it’s all very well to have a document on a shelf but how do you make it live is the next true challenge isn’t ita.

Caroline: Yeah, absolutely.

Scotia: Well, thanks, Caroline for joining us today. It’s always a fascinating conversation and we’re really looking forward to seeing what the framework presents for us and how we can kind of connect in and work more effectively with our colleagues in this work.

Caroline: Great. Thank you. And I’m hoping I’ll be able to discuss the framework with you again and get your feedback before it becomes the final version. We just always, as always, you know, it’s all very rushed, but your your input and your ideas have been really useful so far. So thank you as well, Scotia.

Scotia: Fantastic. All right. All the best with this last dash to the finish line.

Caroline: Yes.

Scotia: Thanks for joining us today and many thanks to Caroline for making the time to speak with me about this important work.

The Natural Disaster Mental Health and Wellbeing Framework will be released in June 2021. We’ll include links in the show notes if you’d like more information and we look forward to hearing more about the Framework as details are released and will continue to share updates on our social media channels.

Creative Responders in Conversation is produced by me, Scotia Monkivitch and my Creative Recovery Network colleague, Jill Robson. Our sound engineer is Tiffany Dimmack and original music is composed by Mikey Squire. Special thanks to Jess O’Callaghan and the team at Audiocraft.

We’ll be back next month with another Conversation, I hope you can join us then. Thanks for listening.