The Australian College of Emergency Medicine, which represents emergency department doctors, notes that Indigenous people use Emergency Departments almost twice as frequently as non-Indigenous people – representing 3 per cent of the population but 5.6 per cent of ED visits. They are more likely than other people to attend an ED for psychiatric illness (3.7% vs. 2.7%); alcohol/drug misuse and alcohol/drug-induced mental disorder (2.7% vs. 0.8%); and social problems (0.9% vs. 0.3%). On the basis of these differences ACEM is advocating for:

• increased awareness and respect of Aboriginal and Torres Strait Islander cultural needs in EDs;
• more Indigenous Health Liaison Officers to be employed in EDs;
• improved data collection of ED patient ethnicity;
• improved emergency medicine physician and trainee knowledge of Aboriginal and Torres Strait Islander health issues and outcomes.

ACEM has a Reconciliation Action Plan at the Innovate level, which includes the development of cultural awareness training for emergency doctors and the extension of continuing professional development modules relevant to the needs of Indigenous people, as well as actions to promote Aboriginal culture through signage and promoting employment opportunities for Aboriginal staff at the college, and support for Indigenous emergency medicine trainees.

Its Statement on Culturally-Competent Care and Cultural Safety in Emergency Medicine (which also applies to Maori and culturally and linguistically diverse people including asylum seekers and refugees) acknowledges the diversity of Aboriginal people while recognising their common experiences: “The health disparities for Aboriginal, Torres Strait Islander and Māori peoples are inseparably linked to the subsequent economic and social disadvantage, institutionalised discrimination and intergenerational trauma.”

This statement is intended to be read alongside the Statement on the Health of the Indigenous Peoples of Australia and New Zealand, which states cultural competence is essential to quality clinical care, and recognises the role of families and communities, including “complex relationships and responsibilities”, in Aboriginal people’s wellbeing. It also discusses building design to make EDs more accessible to Indigenous people, including the need for separate women’s and men’s areas.

To provide better emergency care for Aboriginal patients, ACEM also advocates for the employment and support of Aboriginal staff including liaison officers, and collaborations with local communities – particularly the ACCHO sector – as well as availability of resources and materials in Indigenous languages, including via audio.