Cassandra Blume is an Aboriginal mental health clinician who works in child protection, one of the most complex and sensitive areas to operate.
On any given day, she’s interacting with families, the health specialists around them and children who are working through various levels of trauma.
While the majority of Aboriginal and Torres Strait Islander children are raised in safe homes, the Australian Institute of Health and Welfare (AIHW) says Indigenous kids are overrepresented in child protection and out-of-home care systems.
A recent AIHW report notes that First Nations children were almost 12 times as likely as non-Indigenous children to be in out-of-home care, according to data up to 2022.
Adding to the toll is the historically traumatic experience people have when going through child welfare services.
For Cassandra, the weight of such realities were all too close to home.
So much so, she initially planned on working as a hairdresser far away from any profession that could bring up memories of her past.
“My dad suffered quite significant mental health [issues] and some family members as well because he was raised by a white family so that really affected my dad,” she said.
“And I’ve seen how drug and alcohol abuse kind of took over his life.”
But after taking on a number of different jobs including in a barrister’s chamber and study to be a paralegal, Cassandra felt a deep sense that something was missing.
“I thought I could never really do something that might bring up my trauma [but then] I looked at it in a different way and sat in that uncomfortable space and thought, ‘No, I can do this, I can be there to support someone’,” she said.
This missing element led her to work in the disability sector and from there she landed a role in mental health.
“That was when I thought this is right,” she said.
Not only did Cassandra find a powerful new meaning in her work but she realised it could provide her with answers to better understand the destructive mental health patterns that had hurt her family so much.
“I was just like I just need to understand it more,” she said.
“I feel that that kind of is the reason why children are being removed.
“Because if your mental health is not where it needs to be, you cannot do any of the other things that you’re after.”
Cassandra has since completed a Bachelor of Health Science and Mental Health through Charles Sturt University. A feat she took on while pregnant and raising four children.
“I’m the only child in the family to have a degree,” she said.
“I wanted to make my mum proud and my dad because he had passed away.
“I just thought I got to start somewhere.”
After completing her degree, Cassandra discovered she’d gained a powerful new strength: the authority to speak on complex cases with other healthcare professionals and better advocate for her clients at Kari, a non-profit working to protect Aboriginal children.
“But I could also really push for that cultural part,” she said.
As an Aboriginal academic, Cassandra says her voice is being heard now.
“Otherwise, we’re just another you know – I don’t want to be horrible or racist – but it was almost like just another black person trying to save this person or cover up for them,” she said.
“It was just creating that understanding and then using the language where you’re going to be heard, because they’re like, ‘Oh, this person actually knows what they’re talking about’.”
As an advocate for children and families going through protection and welfare services, Cassandra says it is an ongoing battle trying to convey their humanity and cultural nuances against sometimes overt discrimination and outright racism.
She says Indigenous people experiencing complex mental health issues are often brushed off or treated poorly when they present at places like hospitals.
“I was like I need to learn this, I need to understand this because too many families are being treated in a certain way and then there’s no advocacy,” she said.
“The majority of our clients [at Kari], Aboriginal people, have those flags and they are just looked at differently.”
Cassandra remembers one case where a mother in one of Kari’s perinatal infant mental health programs, who had a history of psychological issues, needed support through her pregnancy.
The plan was to ensure she had a culturally-safe team around her including an Aboriginal midwife.
Unfortunately, the mother gave birth earlier than expected and she went into labour at home.
“The experience that she explained to me was that the paramedics turned up and the baby’s dad came to help her,” she said.
“And when he got there, she [had already] lost a lot of blood.
“She was really unwell [so] he wrapped up the little boy and put him in blankets and just propped him on the floor while he quickly carried her into the bed.
“The ambulance came and they basically had a go at him and said, ‘What parents would leave a baby in the bathroom?’ and he was like, ‘No, she just gave birth, like it was quite horrific for me’.”
Cassandra says harsh and judgemental treatment like this often deters Indigenous people from calling for help
“[This] mum has had a lot of trauma, you know, and she doesn’t look like your average person so [she’s] judged,” she said.
“[She] was seriously ill. She had haemorrhaged and needed a blood transfusion. But they just took the baby and she had to sleep, and [the paramedics] said, ‘Oh, you just bring her to the hospital later.’
“And I thought that was so inappropriate. When would that happen to anyone else?
“They just took the baby and they said, ‘We’re gonna make a report’.
“So that was quite horrible.
“She rang me up crying – she waited in the waiting room for eight hours bleeding out, and they wouldn’t let her see the baby.
“They didn’t attend to her and were basically like, ‘No, your baby is so small. It’s because you’ve taken drugs.’ So they were just making judgments and there weren’t even any issues of drug use while she was pregnant.”
The woman, who had been seeing a midwife and attending all her appointments, asked Cassandra to accompany her to the Neonatal Intensive Care Unit because she didn’t feel safe or comfortable going alone.
“We did make a complaint and I supported her to do that because I said it’s not right,” she said.
Cassandra says better outcomes for vulnerable Indigenous people can only happen if issues like this are properly addressed and this would mean systemic change, a shift in attitudes, more cultural awareness and a higher number of healthcare professionals who are Aboriginal and Torres Strait Islander.
Something she says that works really well at Kari is the clinical team of doctors and other specialists will consult Indigenous staff and have open dialogue on how to approach cases, ask non-judgmental questions and better understand cultural nuances.
She says this could transform the culture and treatment of Indigenous patients at some public hospitals.
“We’ve had people work here who’ve never worked with Aboriginal families and you know, they just fit in so well because they’re just wanting to learn,” she said.
“They’re wanting to understand what it is that they can do or how they can change their practice but still do their job.
“We’ve got people that have come from everywhere like policing or psychology in other places where they say you know, we’ve never worked this way.
“It’s actually amazing.”
Cassandra says the work at Kari is helping break the cycle of poverty and disadvantage by supporting parents with access to fundamental services like occupational therapy, speech and psychology.
“The fact that they’re able to work within Aboriginal homes and be respected by these families just shows that it’s definitely making a change,” she said.
Cassandra’s NAIDOC message to remember all year:
“Why do we do it? It’s for us. It’s for family. It’s for culture to come together, as one – and then just enjoy where we are, and those little milestones that we might have reached.
“Every year we’re bigger, we’re better and we’re stronger as mob – and that’s what we do it for.”
To mark NAIDOC Week 2024, Women’s Agenda has produced a special edition eMagazine in honour and celebration of incredible First Nations women trailblazing across different sectors in healthcare. Thanks to Charles Sturt University’s First Nations Pathways for its support bringing this eMagazine to life.