School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia.
College of Nursing and Health Science, Flinders University, Adelaide, Australia.
Aust Occup Ther J. 2024 Jun;71(3):379-391. doi: 10.1111/1440-1630.12960. Epub 2024 May 8.
Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice.
Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non-government providers in the absence of a local Aboriginal-controlled organisation. Findings were examined critically to identify implications for occupational therapy.
Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non-Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal-controlled services are best positioned to conduct and respond to community consultation.
A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal-controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes.
在澳大利亚政府的“缩小差距”（CTG）战略中，通过咨询将原住民和托雷斯海峡岛民纳入其中一直是政策实施的一个关键特征。然而，咨询往往会强化政府与当地社区之间的权力不平衡，并且可能会低估或边缘化土著知识和领导力。职业治疗在该专业内检查殖民权力结构方面的历史很短，但在去殖民化咨询和实践方面进展有限。
借鉴去殖民化研究方法，并处于知识的交汇处，我们使用比较案例研究来了解两个地区的政策实施情况。在维多利亚州的谢帕顿，CTG 政策主要通过一个原住民社区控制的健康组织来实施，而在南澳大利亚州的阿德莱德南部，由于缺乏当地的原住民控制组织，CTG 政策是通过主流的州政府和非政府提供者来实施的。批判性地检查研究结果，以确定对职业治疗的影响。
我们的案例研究表明，政策利益相关者认为咨询是象征性的，而且原住民和非原住民参与者对合作伙伴关系的看法不同。参与者认为，需要超越与原住民和托雷斯海峡岛民“合作”的言辞，促进原住民领导权，并真正倾听社区的声音，以便政策能够回应当地的需求。这项研究的结果表明，原住民控制的服务最适合进行和回应社区咨询。
对咨询采取去殖民化的方法将改变政策实施的现状，使权力从殖民结构向与原住民领导权的合作以及促进原住民控制的服务转移。从这项关于咨询作为政策实施的一个关键特征的真实、去殖民化的政策实施研究中，职业治疗可以吸取一些经验教训。通过优先考虑原住民领导权和尊重共享的内容来改变权力不平衡，可以推动 CTG 政策实施过程和结果的改变。
