The need to strengthen Australian health and social policy to support survivors of the Stolen Generations

SUMMARY BOX.

• Forced child removals under assimilation policies led to lasting psychological, cultural and social harms, with descendants experiencing higher rates of mental illness, chronic disease, poverty and disconnection from culture and family.

• Stolen Generations survivors face significantly poorer physical and emotional health compared with other Indigenous Australians, with ongoing child removals seen as a continuation of historical injustices.

• Despite national apologies and some state-level reparations, the lack of a unified national framework has resulted in fragmented support and insufficient systemic reform.

• Healing and justice require culturally safe, trauma-informed, community-led services underpinned by human rights, proportionate universalism and strength-based frameworks that recognise Indigenous self-determination.

Historical context

The Stolen Generations are Aboriginal and Torres Strait Islanders who were forcibly removed from their families as children between 1910 and 1970.¹ Hereafter, the term ‘Indigenous’ is used as a collective descriptor. This acknowledges the diversity of Aboriginal and Torres Strait Islander languages and cultures and their status as the First Peoples and custodians of Australia. A 2018–2019 health survey reported that over 27 000 Indigenous people aged 50 and over were survivors of the Stolen Generations, comprising 21% of Indigenous Australians in this age group. Among those, 59% were women and 28% were aged over 65 years.² Most Stolen Generations survivors are aged 50 or older, the age at which Indigenous people require aged care due to significant health disparities.³ Among those removed, 29% lived alone; 66% were over 50 and 20% over 65. In 2014–2015, about 114 800 adults were Stolen Generations descendants, including 15 400 also removed; this group consistently represented around 33% of adults across surveys.⁴ Concerns regarding recent aged care reforms have also been reported in public discourse, including national media coverage, with Stolen Generations survivors expressing particular concern about their implications (ABC News, November 2025).⁵

Colonialism involved powerful political, scientific and religious leaders whose philosophy of eugenics aimed to keep Australian colonies white and ‘like Britain’ as the colonial power. Whiteness was perceived to be associated with greater potential to serve the Empire and assumed to confer superior intelligence and adaptability. Australian authorities classified Indigenous children according to imposed racial categories based on ancestry and skin colour.⁶ The assimilation policies grounded in colonial racial hierarchies sought to control and ultimately eliminate Indigenous identities, languages and cultural continuity. Such practices profoundly disrupted kinship systems and have contributed to enduring intergenerational trauma and inequities experienced by Aboriginal and Torres Strait Islander peoples.⁵

Those Indigenous children deemed to be nearly white were forcibly placed in institutions or foster homes, where they faced significant neglect, abuse, loss of their cultural identity and connections to family and country.⁷ These child removal policies led to profound psychological suffering, cultural rupture and dislocation.^{8 9} The historical context of these separation policies is crucial for understanding the enduring health and well-being effects on Aboriginal families and communities to this day.

Aboriginal communities are deeply concerned about the high rate of Aboriginal children still being removed by governments, with some viewing this removal as ‘another Stolen Generation’.10,14 Aboriginal children are ten times more likely to be in out-of-home care compared with non-Aboriginal children.^{10 11} One report examining the health, cultural and socioeconomic indices of approximately 7900 Indigenous children under the age of 15 years living with a Stolen Generations survivor found poorer health and psychological outcomes across all the measured indices.^{15 16}

Based on Australian Institute of Health and Welfare material, in 2019, over two-thirds of Stolen Generations survivors aged 50 and over lived in New South Wales, Queensland and Western Australia. New South Wales had the highest concentration (31%), followed by Queensland (22%) and Western Australia (18%).⁷ The Northern Territory accounted for approximately 11%, Victoria 10%, South Australia 6%, Tasmania 1% and the Australian Capital Territory at 1%.⁷

Stolen Generation’s physical and emotional well-being

Stolen Generation survivors experience significantly poorer physical and emotional health outcomes compared with Indigenous people who were not removed, compounding inequities experienced by Indigenous people relative to non-Indigenous, and some of these are compounded for Stolen Generations survivors.710 17,19 The trauma of forced removal fostered feelings of isolation, cultural disconnection, social disadvantage and low self-esteem and perpetuates cycles of trauma and inequity across generations.19,21

Children from Stolen Generation households experience 1.8 times more adverse childhood outcomes than other Indigenous children,^{13 22 23} 1.6 times more likely to have poor self-assessed health^{4 24} and experience actual or threatened physical violence (1.9 times), which are strongly associated with accelerated rates of metabolic syndrome (eg, hypertension, type II diabetes and stroke) and psychiatric illness (eg, anxiety, depression, addiction and borderline personality disorder) in adulthood.^{2 25} Childhood stress and trauma have also been linked as a risk factor for developing dementia in later life among First Nations people.²⁶ Furthermore, intergenerational trauma significantly contributes to high rates of chronic unemployment,²⁷ lower rates of educational attainment, poor school retention, mistrust in institutions28,30 and poverty further affecting the children and grandchildren of survivors.^{22 23 25 31 32} Structural barriers and mistrust of government services—including limited service availability, geographic inaccessibility, affordability constraints, language barriers and lack of cultural safety—have significantly restricted healthcare access and further entrenched disadvantage and inequality among Stolen Generations survivors and their communities.²

Policy implications

The evidence of the legacy and intergenerational effects of the Stolen Generations carries significant policy implications. The Bringing Them Home report (1997) called for reparation and extensive policy reforms to focus on injustices inflicted upon the Stolen Generations.^{33 34} Reconciliation efforts included a formal apology by the former Australian Prime Minister Kevin Rudd in 2008 for past injustices against Stolen Generations.³⁵ However, more concrete action is needed to redress the health and social impacts that the Stolen Generations have experienced and continue to experience.²² Despite some perceived progress, current policies are often inadequate in focusing on the ongoing impacts of historical injustice.^{23 25 31} While state financial compensation schemes exist, the lack of a national framework leads to inconsistencies, leaving gaps in support for survivors.^{32 36 37}

Recognition of the Stolen Generations has led to healing and reconciliation programmes. These initiatives include child safety programmes,³⁸ family participation programmes,³⁹ inquiries into police violence,⁴⁰ government-supported services, community-led programmes and advocacy efforts, such as the ‘Healing Foundation’, which supports cultural reconnection and mental health recovery.41,44 The ‘Link-Up’ service helps individuals trace their family histories, restore cultural knowledge, access health services, housing, education and a sense of identity and enhance well-being, which is fundamental for adopting intergenerational trauma.4145,48 Support initiatives, such as housing circumstances of First Nations people,⁴⁹ the First Nations Housing Crisis,⁵⁰ the Australian Bureau of Statistics,⁵¹ Aboriginal housing⁵² support for Aboriginal and Torres Strait Islander communities⁵³ and Ngwala Willumbong Aboriginal Corporation⁵⁴ offer some assistance. Ethical research and advocacy are also essential to amplify survivors’ voices in order to meet their needs for healing and justice.^{11 55}

The policies that led to the Stolen Generations are echoed in current child protection and out-of-home care practices. Family history of child removal is a significant risk factor for ongoing out-of-home care, reinforcing intergenerational trauma stemming from Stolen Generations policies and systemic failures to support families experiencing social health outcomes.56,59 Perpetuation of trauma and disconnection highlights the enduring cultural impacts across generations.⁵⁷ There is an acute gap in supporting families when social health concerns are realised. The antenatal notification mechanism is intended to initiate support, but these are often not realised, and the notifications progress to an infant removal.⁵⁶

Personal stories from the Stolen Generations reveal the profound human cost of these policies, underscoring the need for meaningful reconciliation efforts.^{11 12} Survivors continue to experience significant health, economic and social challenges, particularly those living in remote or very remote areas. These difficulties are intensified by social disadvantage, systemic racism and ongoing marginalisation, as they live with the effects of both past and current policies.60,62 Support initiatives such as the National Redress Scheme,⁶³ NSW Stolen Generations Reparations Scheme,⁶⁴ Indigenous Skills and Employment Programme⁶⁵ and the Healing Foundation employment support⁴² offer some assistance. True healing necessitates the need for targeted policies to address health and social inequalities, amplify survivor voices and a commitment to long-term support for Indigenous Australians.¹⁵

Indigenous communities have also developed holistic and strength-based programmes to mitigate the health impacts of forced removal. These community-led initiatives integrate mental, physical and social health services, as well as fostering cultural healing.⁶⁶ Many programmes feature cultural centres that facilitate heritage reconnection and offer services like mental health support, cultural education and community events, fostering awareness and policy advocacy for Aboriginal people.² Incorporating the history and impacts of the Stolen Generations into educational curricula and public discourse is also seen as vital for fostering empathy, understanding and increasing awareness.3367,69 Support initiatives such as Indigenous Education Strategies,⁷⁰ Indigenous Education,⁷¹ education of First Nations people,⁷² Ngarrngga Project,⁷³ curriculum changes⁷⁴ offer some assistance.

A major challenge for the Stolen Generations and their descendants is the lack of accessible, culturally appropriate mental health services. Delivering this requires expanding digital mental health options in remote and rural areas, as well as providing age-appropriate mental health services for older adults.⁶² Such services require collaboration among government, non-government organisations and Indigenous communities to prevent further trauma, enhance support and avoid perpetuating historical injustices.^{75 76} Solutions must align with the long-term aspirations of Indigenous communities.⁷⁶ Co-designed healthcare strategies empower survivors, reduce incarceration, focus on complex trauma and support the goals of the Closing the Gap initiative.77,79 Ensuring these services reach remote and regional areas is crucial, as is training provided in trauma-informed care.80,82 The commissioner’s 2021 report also outlines evidence-based actions to create a culturally safe and responsive aged care system. Clear funding allocation is needed to ensure they age with dignity and support.^{3 5} The 2025–2026 pre-budget submission urges strategic investment to tackle Stolen Generations survivors’ complex ageing needs. Finally, the government must ensure monitoring and accountability to implement remaining recommendations effectively and transparently.^{5 83} One proposed solution, framed as a social insurance approach, is to fund the aged care system through a levy on superannuation that increases with age cohorts.⁸⁴

A recent review highlighted shortcomings in the Closing the Gap framework, noting that it remains in a ‘business as usual’ state since its 2008 implementation. Some health targets have regressed due to structural barriers and systemic racism.¹⁰ Re-establishing access to cultural and community connections for survivors and other Indigenous community members, family and kinship networks of survivors (that may include Indigenous and non-Indigenous people) remains crucial from a contemporary cultural perspective.¹⁹ The disconnection from community, country and culture remains a core issue in health outcomes, contributing to ‘the gap within the gap’.^{19 85 86} Adopting the broader social determinants of health, including structural inequalities, is essential for meaningful change (Article II(e) refers to a provision in the 1948 United Nations Convention on the Prevention and Punishment of the Crime of Genocide (Genocide Convention), which defines genocide to include ‘forcibly transferring children of the group to another group’ as an act of genocide when committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group as such⁸⁷). Policy action must also be filtered downwards into everyday practice to positively impact the well-being of the Stolen Generations.

Australia could plausibly face a genocide claim at the International Court of Justice for Stolen Generations policies. Current jurisprudence makes success unlikely, but reforming standards of proof and genocidal intent could enable meaningful Article II(e) claims and align decisions with the Genocide Convention’s purpose.⁸⁸ In this context, table 1 synthesises the historical policy impacts, current policy developments and their broader implications for Indigenous well-being, with particular emphasis on the experiences of the Stolen Generations.

Table 1. Historical and present-day policies and their impacts on Indigenous communities and Stolen Generations survivors.

Domain	Historical policy impact	Current policy developments	Relevance	Holistic policy implications
Healthcare	Denial of culturally appropriate care and forced removals and trauma21	Closing the Gap,97 Link-Up46 and Healing Foundation42	High rates of chronic disease, post-traumatic stress disorder, limited access and mistrust of health services7	Co-designed, trauma-informed, expanding digital and culturally safe mental health services outreach in rural areas62 78
Social support	Loss of family/community connection and institutional abuse17	Healing Foundation42 and compensation payments36	Social exclusion, identity loss and poor emotional well-being17	Culturally grounded healing services and permanent support for survivors43
Economic	Denied employment and land rights and forced dependency85	The National Redress Scheme,63 NSW Stolen Generations Reparations Scheme,64 The Healing Foundation employment support,42 Indigenous Skills and Employment Programme65	Intergenerational poverty and high unemployment27	Economic empowerment via community-led programmes, job creation and reparations44 62
Education	Denied access to quality education; unnecessary suspensions and exclusions30	Indigenous Education Strategies,70 Indigenous Education71 and Education of First Nations people72 Ngarrngga Project. A transdisciplinary education programme embedding Indigenous knowledge systems into school curricula73 and curriculum changes74	Low literacy, poor school retention and mistrust in institutions28 29	Incorporate Indigenous history in education, community-led learning68 and empowerment via truth-telling and storytelling98
Safety	Institutional abuse and systemic racism61	Child safety programmes,38 Family Participation Programme39 and inquiries into police violence40	Over-representation in child protection and policing8	Adopt systemic racism in policing and trauma-informed training81
Child Protection	Stolen Generations removals and foster/institutional abuse9	High rates of current removals,13 socioeconomic outcome area16 and Culture and Empowering Communities82	Ongoing removals and ‘another Stolen Generation’ concerns14	Advocates culturally appropriate kinship care and community-led family supports
Justice	Criminalisation of Indigenous people and systemic bias55	Justice reinvestment pilots,89 Maranguka,90 National Justice Reinvestment Programme,89 Royal Commission,99 Australian Human Rights Commission91 and Parliamentary Business92	Overincarceration and intergenerational trauma17	Implement restorative justice, dismantle power structures to reflect decolonising processes within the justice/legal system and restoring relationships25 31
Housing	Displacement from land and community86	Housing circumstances of First Nations people,49 First Nations Housing Crisis,50 Australian Bureau of Statistics,51 Aboriginal housing,52 support for Aboriginal and Torres Strait Islander communities53 and Ngwala Willumbong Aboriginal Corporation54	Overcrowding, homelessness and housing insecurity47	Safe, affordable and culturally connected housing programmes48

Recommendations for future policy consideration

To effectively direct the intergenerational impacts of colonisation and promote justice for Indigenous Australians, policy reform must prioritise co-designed, culturally safe services across all sectors.¹⁷ This includes supporting healing from cycles of intergenerational trauma through comprehensive healing programmes, restoring justice and culturally appropriate kinship care systems, expanding community-led economic and educational initiatives and dismantling structural racism. Achieving lasting change requires the full integration of these principles into all levels of government and community responses through sustained, holistic and long-term approaches aimed at closing the gap and promoting equity. Support initiatives such as Justice reinvestment pilots,⁸⁹ Maranguka,⁹⁰ National Justice Reinvestment Programme,⁸⁹ Royal Commission,⁸⁹ Australian Human Rights Commission⁹¹ and Parliamentary Business⁹² offer some assistance.

The origins and architecture of these policies, however, lie far beyond the health and social services system. While the policy and systems changes discussed in this paper are necessary, they are not sufficient conditions to provide the full answers. This is because colonial and eugenicist policies continue to have a far-reaching effect on all aspects of the lives of Indigenous Australians.

International human rights covenants underpin policies and programmes for Indigenous peoples in Australia. A rights-based approach recognises people’s entitlement to services by their humanity, not their deficits.⁶ Strength-based ‘glass half full’ frameworks are evident in several programmes discussed.⁹³ An important document is the United Nations Declaration on the Rights of Indigenous Peoples, adopted in 2007. Australia was one of a handful of countries to vote against it but reversed its position following advocacy from Indigenous peoples. The Declaration forwards the rights of Indigenous peoples to live in dignity, maintain and strengthen their own institutions, cultures and traditions and pursue their self-determined development, in keeping with their own needs and aspirations.⁶ International human rights approaches, however, must be tailored for Australia, exemplified by a report card on progress towards realising the rights of Indigenous children. The report card modified the United Nations Convention on the Rights of the Child for local conditions by adding three rights: detention as a last resort, growing up in a culture and growing up with family and community.⁶ Rights approaches often stimulate a combination of social movements, academic evidence and broad-based coalitions to influence Indigenous health policy by foregrounding social and cultural determinants alongside self-determination.⁹⁴

Rights approaches are consistent with proportionate universalism: ‘Actions should be universal, but with an intensity and a scale that is proportional to the level of disadvantage’.⁹⁵ This policy framing is useful because it combines the benefits of universal interventions with resource allocation that is equitable for the health and well-being of Indigenous Australians. Moreover, it avoids the dominant framing of Indigenous people as inherently marginalised or vulnerable. Proportionate universalism also resonates with an Indigenous strength-based or glass half-full epistemology rejecting a deficit approach framing Aboriginal and Torres Strait Islander peoples as problems to be fixed. A glass half-full approach learns from the strengths, assets and successes.⁹³

International guidance for speaking about the social determinants of health includes frameworks from the WHO and the National Institute of Minority Health and Health Disparities, which can inform transformative change and health equity for the Stolen Generations and their descendants.^{75 96} However, they cannot be transferred uncritically without developing a deep understanding of how the social determinants of Indigenous health differ from those derived from high-income, non-Indigenous populations. An analysis of a textbook and a series of short courses about Indigenous determinants of health revealed three groups of determinants. The first two involved either transferring or modifying more generic social determinants for Indigenous health in Australia. The third group, however, was specific to an understanding of health and well-being in Indigenous Australia. These were history, racism, country, policy processes and sustainable programmes.⁹³ As in the case of the human rights example above, international statements have a strong role if there is an explicit process of tailoring for local contexts.

In conclusion, this perspective paper has proposed policies to redress the health and well-being of the Stolen Generations. Previous policies have colonial and racist roots, and their intergenerational effects are seen in both Stolen Generation survivors and their families. While there are examples of progress within the health system and by Indigenous-led programmes, a more comprehensive approach to research for policy development could draw upon the power of human rights and strength-based approaches, led by Indigenous communities and informed by social movements. In doing so, we can improve social policies over the life course.

Data availability statement

All data relevant to the study are included in the article.