A history of marginalisation and cultural dispossession has contributed to lower emotional and social wellbeing among Aboriginal Victorians, the state's mental health royal commission has heard.

Key points: Aboriginal Victorians are twice as likely to be hospitalised for mental health issues, compared to the wider population

Aboriginal Victorians are twice as likely to be hospitalised for mental health issues, compared to the wider population Almost half of the state's Aboriginal population has a relative who was removed under the policies which lead to the Stolen Generations

Almost half of the state's Aboriginal population has a relative who was removed under the policies which lead to the Stolen Generations One elder told the commission the western concept of mental health was neither familiar, nor helpful for Aboriginal people

Wemba Wemba elder Auntie Nellie Flagg described the mental anguish that accompanied the relentless racism she experienced growing up in the north-west Victorian town of Swan Hill in the 1960s.

"I couldn't walk away from it. Everywhere I went it surrounded me," she said.

"It saddens you, it really embeds in you that people don't like me because I'm black."

Ms Flagg recounted having stones thrown at her, being followed in shops, barred from restaurants and ostracised by other children.

"Once I had a car driven at me while walking home from netball and footy training," she told the commission.

"I learnt very quickly there are things I can do and there are things I can't do and places I don't want to be."

Ms Flagg said the western concept of mental health was neither familiar nor helpful for Aboriginal people, who see physical and emotional wellbeing as one.

"Growing up we didn't have a word for mental health. It was well-being, it was caring, it was sharing, it was about all that," she said.

Mental anguish and premature death went hand in hand, she said, pointing to the dozen or so young family members she has seen die young.

"Some were natural causes, some were from suicides, and again the abuse that happened back years ago to people that went unrecognised," she said.

"It's not an isolated situation.

"There's too many deaths in our community and a lot of them can be prevented."

Losing life to suicide at twice the rate

The inquiry heard evidence of a widening gap in mental health for Aboriginal and Torres Strait Islander people, compared to the general population.

Aboriginal Victorians were twice as likely to be hospitalised for mental health issues and three times more likely to experience high levels of psychological distress, the commission heard.

Helen Kennedy said culturally appropriate services were critical. ( ABC News: Danielle Bonica )

Helen Kennedy, from the Victorian Aboriginal Community Controlled Health Organisation, said: "They're losing their life to suicide at twice the rate."

"We're not seeing improvements."

Ms Kennedy told the commission part of the problem was a lack of recognition of the profound trauma arising from a long history of marginalisation and the dispossession of land, culture and children.

Almost half of all Aboriginal Victorians have a relative who was removed under policies which lead to the Stolen Generations.

"These impacts have been brutal," Ms Kennedy said.

"They have left a legacy of enduring trauma and loss that continues to affect Aboriginal communities, families and many individuals is in many compounding ways."

Culturally appropriate services critical

Ms Kennedy told the inquiry that developing culturally appropriate services staffed by Aboriginal people was critical.

She said Victoria had only eight Aboriginal mental health workers statewide.

"We are lagging behind other states," she said.

"We need a massive reinvestment to support a growing skilled Aboriginal workforce."

Ms Kennedy said one approach proving successful elsewhere was the creation of trauma-informed community "healing centres" aimed at helping individuals build stronger connections to culture, community, family, spirituality, their mind and emotions.

"What we're doing now is not working. We have to have a different approach," she said.

"Looking after people's social and emotional wellbeing and supporting protective factors … we know that works."