By Ed Mosby, Psychologist and CEO, Wakai Waian Healing
January 26 continues to expose a deep fault line in Australia’s national story. For many Aboriginal and Torres Strait Islander peoples, it marks invasion, dispossession and the beginning of systemic exclusion that remains visible today in our laws, institutions and health outcomes.
As a psychologist working in Aboriginal and Torres Strait Islander mental health, alcohol and other drug services, and suicide prevention, I see every day that this history is not abstract. It is measurable. It is present in the Closing the Gap data, in service access, in workforce composition, and in who holds power in systems designed to “help” our communities.
Despite decades of policy attention, the 2023 Closing the Gap report confirms that most targets related to health, wellbeing and incarceration are not on track. Suicide rates among Aboriginal and Torres Strait Islander people remain unacceptably high. Rates of psychological distress are more than double those of non-Indigenous Australians. These outcomes are not the result of individual failure. They are the predictable consequences of structural inequality, cultural disconnection and systems that have not been designed with, or led by, our people.
Truth-telling matters because effective mental health reform depends on it. We cannot address trauma without acknowledging its sources. Colonisation, forced removals, institutional racism and ongoing exclusion from decision-making continue to shape mental health outcomes across generations. Research consistently shows that experiences of racism are associated with higher rates of psychological distress, anxiety and depression. Cultural continuity, self-determination and community control, by contrast, are protective factors.
Yet Aboriginal and Torres Strait Islander people remain structurally marginalised, including at the highest levels of national recognition. We are still not recognised in the Australian Constitution. That absence is not symbolic alone. It reflects a broader pattern in which Indigenous voices are consulted late, inconsistently, or not at all, and it reinforces power imbalances that flow through policy, funding and service delivery.
One area where these dynamics are especially visible is the mental health workforce itself. Aboriginal and Torres Strait Islander psychologists are critically underrepresented. Current data indicates that less than one per cent of registered psychologists identify as Aboriginal or Torres Strait Islander, while our people make up more than three per cent of the population and experience a disproportionate burden of mental ill-health. This mismatch affects trust, access, early engagement and continuity of care.
Workforce shortages in regional and remote areas compound the issue. Too often, communities are left with short-term, fly-in fly-out services that struggle to build relationships or understand local context. Evidence shows that continuity of care, culturally safe practice and long-term workforce presence are key to effective mental health and suicide prevention outcomes.
At Wakai Waian Healing, an Aboriginal and Torres Strait Islander–led organisation operating across Queensland, we have taken a deliberate, long-term approach to addressing this gap. Rather than asking how to recruit clinicians into communities temporarily, we focus on how to grow and retain them sustainably. This includes supporting Aboriginal and Torres Strait Islander students, provisional psychologists and early-career clinicians through structured supervision, cultural governance and workplace environments that recognise the whole person, not just their clinical role.
This work is slow by design. It is built one internship, one placement and one mentoring relationship at a time. But it reflects what research and communities consistently tell us: culturally grounded, place-based care delivered by a stable workforce improves engagement, reduces crisis presentations and strengthens long-term outcomes.
Australia Day presents an opportunity for honesty. Not for blame, but for responsibility. If we are serious about Closing the Gap, we must move beyond rhetoric and address the foundations of our systems. That includes truth-telling about history, recognition of Aboriginal and Torres Strait Islander peoples, genuine power-sharing in decision-making, and sustained investment in Indigenous-led services and workforces.
Mental health reform will not succeed if it ignores culture, history and structure. Healing is not achieved through programs alone. It is built through trust, continuity and respect, and through systems that are willing to change themselves.
Until we are prepared to confront these realities, January 26 will remain a reminder not of unity achieved, but of work unfinished.