Transcript Keep It Safe: Whole Family Team

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.