Shared Responsibility in Action- Whole Family Teams August 2012

KTS Whole Family Team Beginnings Nov 2008 Special Commission Report – Justice James Woods highlighted that Mental Health and Drug & Alcohol issues for parents and carers had been identified as significant factors in child protection reports and outcomes March 2009 KTS ‘Keep Them Safe’ released; this included a commitment to improve how services are delivered to parents with substance misuse and mental health issues where there are child protection concerns Health Programs for Keep Them Safe included funding for a pilot program of Whole Family Teams. The Whole Family Teams are tertiary specialist child focussed and family centred mental health and drug and alcohol services located in Nowra, Gosford, Newcastle and Lismore June to December 2010: Interagency planning for Model of Care for WFTs Pilot sites notified

Mental Health and Drug & Alcohol Whole Family Teams $28m over 5 years protected item funding Target group at tertiary end (priority for Community Services’ clients) This means that these new services are seeing families where there have been reports of the children being at risk of significant harm Statewide Steering Group established Model of Care developed and ratified

Keep Them Safe - Whole Family Teams (KTS-WFTs) The governance model aimed to ensure that all stakeholders in this multidisciplinary and inter-agency model had input into the service design and implementation. Led by MH & D&A but the Steering Committee includes representatives from each of the health districts involved in the trial and Community Services. “Will provide comprehensive assessments and group, family and individual interventions over a 6 month period”

Who We Are - Skill Mix Social Workers, Psychologists, Nurses and Aboriginal Health Workers, Consultant Psychiatry and D&A Visiting Medical Officers Recruitment over the first period of operation, and when vacancies occur, targets particular disciplines and program experience to meet identified needs Within the team, there is capacity for interventions such as family work, individual work and group educational and therapeutic programs when clinically indicated Extensive experience in Mental Health, Drug and Alcohol and Child & Family focussed work Local and cultural knowledge

What have We Offered? Comprehensive Assessment Care Plan Developed Therapeutic Intervention for identified individual issues, sometimes by referral Family Focus – systemic intervention Parents Under Pressure Circle of Security

Significance of WFT to MH & AOD Aligns with key strategic directions for MH and D&A, eg., Family & Carer, MUMS, Safe Start, COPMI, D&A Co-morbidity WFT offers additional useful service to their clients, and partnerships with MH and D&A clinicians Thus, has had effect of increasing awareness and understanding of child well-being issues, more effective family work and appropriate ROSH reporting to FaCS.

Joint WFT/FaCS Half Day Review, Presented Woods background, creation of WFT pilots and establishment of Lismore Team Looked in detail at about 6 families Identified communication and process issues, noting that even over this small number of referrals, processes had become smoother –WFT initial response time –FaCS identification and referral description of parental MH and D&A issues –Joint presentations to families of the issues requiring attention –Discussion of the fine line between voluntary engagement with WFT and FaCS requirements for child safety and well-being –Some discussion of joint FaCS/WFT reviews with families

Ongoing Partnerships Family & Community Services Partnership - Communication and Referral Pathway between FaCS and WFT is smooth, regular & structured. Building collaborative relationships and referral pathways with Mental Health, Drug and Alcohol and Koori Clinic Strong general interagency participation and information flow. Whole Family Team Reference Group includes Community Services, MH, D&A, Child Protection, Aboriginal Health

Challenges of Shared Responsibility Collaboration commenced as a “top-down” policy directive, and those tasked with implementing it had a stake in shaping its meaning in practice. “trust” cannot be mandated but must be developed and nurtured if the intentions of Keep Them Safe are to be met. Effective implementation needs to be based on mutual understanding and clear communication, we speak different languages. Inter-organisational collaboration in human services is difficult because of the multiple and complex nature of inherent potential sources of conflict, and these include resources, multiple accountabilities, professional differences, procedural and structural barriers, as well as issues of status, power and legitimacy.

Challenges of Shared Responsibility Barriers to collaboration in child protection reflect the collaboration literature generally, but research highlight some specific barriers in the areas of mental health and AOD The concern of child protection workers is child safety and stability whereas traditionally mental health and AOD have been parent focussed. Therapeutic timeframes are under new pressure when child protection concerns are present. Further to these tensions, each agency has its own history, narrative of past relationships, and past patterns of interaction. Implementation studies find that frontline staff often reject policy mandates that conflict with their values and beliefs about their core business.

Summary of Key Differences in AOD and Child Protection Practice

What Works Strong Governance where all voices are heard Establishing the rules of engagement Understanding and respect of each others values, looking for the common ground Commitment of all agencies to contribute to each others learning A Shared focus on the risk to the child and the parent and carer Joint training Fierce Conversations Adequate resources and opportunities for joint goal setting and problem solving and organisational support for collaboration.