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Finance and Public Administration References Committee
08/11/2017
Delivery of national outcome 4 of the National Plan to Reduce Violence Against Women and Their Children 2010-2022

GILLESPIE, Ms Annette, Chief Executive Officer, safe steps Family Violence Response Centre

MANGAN, Ms Diane, Chief Executive Officer, DV Connect

CHAIR: I now welcome Ms Annette Gillespie, from safe steps Family Violence Response Centre, and Ms Diane Mangan, from DV Connect. I understand that information on parliamentary privilege and the protection of witnesses in giving evidence to Senate committees has been provided to you. safe steps has lodged submission No. 13 and DV Connect has lodged submission No. 47 with the committee. Do you wish to make any amendments to those submissions?

Ms Gillespie : No.

CHAIR: I invite you to make a short opening statement. At the conclusion of your remarks members of the committee will have questions for you.

Ms Gillespie : On behalf of safe steps Family Violence Response Centre I am pleased to have the opportunity to appear today and to speak to our submission to the inquiry into the delivery of national outcome 4 of the National Plan to Reduce Violence Against Women and their Children. I would also like to acknowledge the senators in attendance today and thank them for their commitment to delivering a world-class trauma counselling service for all those who have experienced sexual assault and domestic and family violence through 1800RESPECT.

safe steps Family Violence Response Centre holds over 40 years of experience as a service working to end violence against women and their children. Our collaboration with DV Connect and Women’s Safety Services South Australia to deliver specialist trauma counselling on behalf of 1800RESPECT yields a combined experience of more than a century in the field. While safe steps is understandably renowned for our 24/7 state-wide telephone support line, which responds directly to the needs of women and their children who have experienced family violence, our work goes far beyond this and is built upon a respond, prevent and recover framework.

Amongst our many programs we currently deliver risk assessment and safety planning, emergency accommodation, survivor support programs in both the Magistrate Courts and Family Courts, advocacy and support initiatives and prevention initiatives, including the annual Candlelight Vigil and the Walk Against Family Violence and our Survivor Advocate Program, which will soon commemorate its 10-year anniversary. We are a feminist organisation and recognise that family violence and sexual assault are perpetrated, in the vast majority of instances, by men against women, children and other men.

The nature of the way that women choose to access the family violence and sexual assault prevention, response and recovery service is changing as awareness and access are increasing. This, too, necessitates that services like ours constantly re-evaluate the work that we do. Over the past year, in particular, our Victorian 24-hour direct client support team has noted that the increase in calls that we have experienced seems to align with an increase in women coming forward earlier and seeking information which will help them to establish whether what they are experiencing is indeed family violence and sexual assault and where they can access the supports that they need.

We know that awareness campaigns by both state and federal governments have shone a light into dark places and, in many cases, have encouraged victim survivors to feel safe coming forward, sharing their stories and seeking support in greater numbers. For those delivering the services that victim survivors rely on, this has translated in a sometimes dramatic increase in demand. Our state-wide 24-hour telephone line received over 90,000 calls in the 2016-17 financial year. We believe we haven't yet reached peak demand and that this will only continue to grow.

As we've seen in Victoria, the resourcing required to support our work in family violence and sexual assault prevention, response and recovery must grow alongside the increase in demand. There is no women's service in the country who would deny that we always need more resourcing. We are all well practised in running on the smell of an oily rag. But in this case the federal government has increased rather than decreased its financial allocation to 1800RESPECT trauma counselling across the board. And the number of specialist trauma counsellors the panel providers have been engaged to employ, at 48, is the highest in 1800RESPECT's history.

The Australian Services Union NSW & ACT Branch have argued in their submission that, because of the complexity of sexual and family violence, the sector which delivers services to women, children and men living with, escaping or surviving violence is best delivered by a collaboration of government agencies and not-for-profit specialist community based organisations. As statewide providers, we have long held the view that 1800RESPECT would be best delivered as a truly national collaboration between like-minded specialist not-for-profit providers. This would, likewise, strengthen the referral process between the national trauma counselling service and the statewide services. The new 1800RESPECT panel provider approach recognises that the increase in demand at a national level is such that clients will be best served by a collaborative approach rather than one provider in one location going it alone. We are sincerely disappointed that the previous provider elected not to enter into this collaborative partnership arrangement, but we feel strongly that the remaining three providers are well equipped to deliver an uninterrupted world-class service with support from the federal government.

We are deeply concerned by public statements and campaigns which have the potential to lessen the trust that victim-survivors place in the specialist trauma counselling service provided by1800RESPECT and we are disheartened to see submissions to this inquiry from organisations indicating they will no longer refer women to 1800RESPECT on the basis of misinformation around the future provision of the service. In regard to some of these comments, I would like to state unequivocally that the skill and experience of our practitioners is world class. Any suggestion that the 48 FTE specialist trauma counsellors who have been engaged by our three services—who all hold relevant university qualifications of three years or more, together with at least three years professional experience—are somehow underprepared to deliver this service should be regarded as deeply insulting. We are committed to providing a workplace in which our staff are valued and respected for the extraordinarily challenging work that they do—where clinical supervision is provided and where training is applied through a feminist framework that recognises the intersexual ways in which women, children and all victim-survivors may experience disadvantage.

safe steps Family Violence Response has a 100 percent success rate in defending subpoenas, which, regretfully, are a common occurrence in our industry. We are committed absolutely to protecting the safety and confidentiality of the women we work for. safe steps supports changes to improve the triage model and we believe we are best placed to advocate for those changes from the inside as a service provider. We are proud to say that, alongside DV Connect and Women's Safety Services, we commenced providing 24-hour specialist trauma counselling services on behalf of 1800RESPECT from 29 October this year. We welcome the opportunities which may arise from the inquiry to clarify any misunderstandings about the future delivery of this service and to further develop Australia's national sexual assault, domestic and family violence counselling service as the very best service that it can be.

CHAIR: Thank you, Ms Gillespie. Ms Mangan, do you wish to make an opening statement?

Ms Mangan : Not necessarily. I would like to support what safe steps have said. I would also like to advise the panel of senators that, for many years, we have wanted the service delivery of the national service shared out across the different states. Right from when John Howard first gave the contract to Lifeline, we provided information at that time that this should be a role provided around the country. I was aware of the submission by RDVSA, which I supported at the time. At the time it was New South Wales Rape Crisis, but I had the confidence that a qualified service would be able to have the domestic violence expertise or be able to recruit women and see that they were trained to provide that, which is similar to what we are saying now. We are also capable of recruiting suitably qualified women and seeing that they're properly trained to answer these calls.

CHAIR: Thanks very much. Perhaps we can go to this process by which your organisation's building up the capability. You've said, and other witnesses have said also, that this was a process that RDVSA also went through. How are you approaching the question of leadership? What's occurred to me in listening to the evidence provided by MHS, which has been largely around reminding us of the qualifications required for the individual counsellors, is that those remarks don't really go to culture and establishing an organisation with systems, processes and culture that are able to support a unified counselling model that's consistent over time. It strikes me that, amongst other things, it requires clinical leadership. How is that being organised in each of your services?

Ms Gillespie : I think a couple of things are very important to understand. One is that the counsellors are employed by each of the organisations, so they fall within the clinical practice frameworks of the organisation that they are employed with, in addition to the ones that we develop jointly as 1800RESPECT service providers. Secondly, we have worked together as the three providers to ensure that the leadership is consistent across the three services so that, no matter where somebody might be calling the service from, they get a consistent response for that service. We've worked very hard in the last few months to make sure that not only is the service consistent but also the culture and leadership within each of the teams are consistent. There are clinical leaders employed in each of the services. There are program leaders in addition to that, and then the program falls within each organisation's clinical service structure.

CHAIR: Are all those personnel in place in each of your organisations?

Ms Gillespie : Yes.

Ms Mangan : Yes. I'd just like to add too that we're responsible for our own professional reputations. In the partnership with Medibank, their responsibility is for delivering the infrastructure around that, but we are also very responsible for the delivery of the counselling model. We have been working very closely with them on a daily basis, with weekly teleconferences on three different tiers, and providing feedback on how we want the clinical model to look, and we have found Medibank receptive.

CHAIR: Where are we up to with the model? I'm a bit unclear about what documentation presently exists to guide delivery of the service in each of your organisations.

Ms Gillespie : Just to preface that: prior to signing the contract, we negotiated that any clinical model would be developed jointly by the organisations—at that time we thought it would be four coming on board, but then three—because we realised that it was going to be a different way of delivering the service than had been delivered in the past, moving from one provider to three or four providers, so that needed to be reviewed to make sure that the model was going to be robust enough to make that—

CHAIR: So where are we up to? Has it happened?

Ms Gillespie : Yes, it has, and continues to—sorry, you're pushing me along.

CHAIR: Sorry, I don't mean to sound brusque; I'm just conscious that I've got to give some time to other senators, and this is my last question.

Ms Gillespie : Please be very direct. We have a clinical governance framework that is in place, which we have agreed to. It will also be reviewed on an ongoing basis, but it's what we're working to right now. But we also have a guidance on trauma-informed practice, so there is a specific document providing trauma-informed practice for the counsellors, and then there is a clinical governance framework that that sits underneath.

CHAIR: I think MHS has undertaken to provide that to us. Are you in a position to provide that to us?

Ms Gillespie : Yes, absolutely.

CHAIR: Thank you.

Senator PATERSON: Ms Gillespie, you partly covered this in your opening statement, but I want to bring you back to the issue of the public controversy and criticism of the change in delivery and your concerns about how that will impact women potentially thinking about taking advantage of these services. Can you just clarify what your concerns are? Do you think that there are women who may not call this new service because of the criticism that's been made?

Ms Gillespie : We know that two things have happened already. We've heard feedback from other service providers that they were uncertain about whether 1800RESPECT was continuing and, if so, what the quality of service would be, so they were checking with us to understand better what that service delivery was going to be like post 29 October. So we know that, in the service sectors, there is concern and that people are not sure whether they should refer or not. We've had to reassure service providers who are referring clients.

But we also know about the clients themselves in the first week—and it's only been a week. There have been callers who have rung the service to check whether in fact it's still there. They are previous users of the service, and they've run to check whether in fact that number is still live and people are still there to support them. So already we've seen two direct impacts.

Ms Mangan : I worked on the first night. I did the night shift with the program leader because I wanted to get my own experience on what I needed to make sure all of our counsellors were able to provide. We were very aware of a number of callers asking what the qualifications were, what we'd do with notes and what we'd do around subpoenas. We expected a number of those calls, so we were quite pleased to get them, and we were hoping to assure callers that we would aspire to provide the same high standard that they were getting from RDVSA.

Senator PATERSON: Do you think the criticism's been fair?

Ms Mangan : It's been uninformed, and I actually think that's the major concern. I think people have felt there's a level to trauma that only a person with the most extreme training—and only a few people in the world have that ability. If you don't work in this field, you could believe it. It's not true. There is a whole lot about your professional background and your training. We work with women. I've been working with women and children and family violence for 40 years, so I know trauma. I know complex trauma. And I know what resistance is, and I also know what strengths are. To assume that everybody who phones the call line is a victim of trauma, a paralysed victim of trauma, is misleading. There are strengths about these callers. These were some of the calls I actually took that night. I needed to be assured myself that this was the service—because we are very respectful of RDVSA and we wanted to make sure that we were following in their footsteps. I was happy to say that, from the conversations I heard the counsellors having, the debriefing we did afterwards and my own calls, I felt we could do it.

Senator PATERSON: Whether they meant to or not, the criticism by people like RDVSA and the ASU is an implied criticism of you and the services that you offer and the quality of them. I want to give you an opportunity to respond to that and to seek your assurance that you will be able to deliver a high-quality service.

Ms Mangan : Well, we've been doing this for many, many years, and it's not just us personally; it's the teams behind us. We speak to thousands of women every year. We get women to safety all over our states, night and day. We have a men's line. We have a sexual assault line. We have a pets and crisis program. We are looking at a holistic response, and a lot of the calls who come to us are not women wanting to go immediately, so there's a lot to manage around these calls. We are very capable of providing that service.

Where the national service has been a godsend for us is that, where the woman's immediate safety isn't the issue, we have been able to transfer those calls to a service who could provide them, only because of time. We didn't have the staffing. We wanted to do it, but we couldn't do it and have calls in the queue for women who may need their safety needs met. We've always wanted those resources so that as a service we could have a part of our service delivery providing that therapeutic counselling.

Senator PATERSON: We heard evidence from RDVSA that 98 per cent of the people who call do need trauma counselling. From your experience, does that sound like an accurate or reasonable figure? It sounds high to me—without being an expert myself, obviously.

Ms Gillespie : Based on our experience, and on my own anecdotal practice experience, it sounds very high. I would think it's much more likely to be around 25 per cent that would need intensive trauma informed—not really even need, but be seeking. The majority of women are seeking anything from information to practical solutions and safety. Often, women calling are at a very contemplative stage of learning about family violence and making decisions about what they want to do with their relationship. To suggest that those women require a trauma informed response is, in fact, doing them a disservice. I'll add one thing: all women, or people, who experience family violence experience a level of trauma, but not everyone requires a trauma informed response or is in fact seeking it. I think it's being discerning about at which time women do require that response.

Senator SINGH: Can I ask why? You seem to be slightly contradicting yourself in the sense that you said that every woman that experiences family violence experiences some sort of trauma but then you're saying at the same time that they don't always require a trauma informed response. I don't quite understand how you get to that conclusion.

Ms Mangan : It's their management of it.

Ms Gillespie : It's not that the response isn't informed by trauma, it's that the women themselves may not be seeking a trauma response at the time that they make the call. They may be seeking a much more practical solution.

Ms Mangan : This is very much so with domestic violence. We're often dealing with different needs and wishes from the women at the time. Then, within domestic violence, there are those who need to leave immediately and those who don't but are living with the same violence—they're not in a position to leave. About one-third of the women we speak to are women who are well educated, are financially secure and have wonderful networks, and they feel a high level of shame—'I should know better.' That's how they see it. Our role is to try to bring them back to, 'This is not about you; this is about what's being done to you.' That there requires, you know, an element of acknowledging the trauma. But many of the trauma cases that we find that need that intensive work are those that come through on the sexual assault line, particularly those where women have been abused as children and they've had those years of trying to come to terms with not only the abuse but who didn't protect them at the time. There are so many elements. I had 18 years in child safety. You learn these things. You watch and observe as well as develop and hone your skills around it. This is what our experience is. We're not contradicting what others are finding; we can only say what we are finding.

Senator PATERSON: Why is it important that every call is answered by a human being and dealt with promptly?

Ms Mangan : I personally get very distressed when I see calls in the queue that are not answered, and will find myself sitting there until all hours of the day and night trying to get those calls out, because you never know what that call is. You never know whether that's the first or possibly the last time they'll call. It's important for us. Under our state funding, we have obligations to meet the contractual demands, and that means proving to the department your ability to be efficient as well as never forgetting the safety needs of the caller, and we can do it.

Ms Gillespie : I think also that the confidence that women require to be in contact with the service—if the call goes unanswered, then they lose confidence in being able to reach out. It can be life threatening.

Senator RICE: In the discussion about the proportion of women needing specialist trauma counselling, I wanted to clarify: my understanding is that everybody ringing your services would require a trauma informed response. They may not require specialist trauma counselling at that stage, but they do need to have their call taken in context and by people who understand trauma.

Ms Gillespie : Yes.

Senator RICE: That's not what you said before.

Ms Gillespie : That was my intention.

Senator RICE: That was to clarify that. Secondly, you talked about the development of your clinical model, which is underway in collaboration with MHS. RDVSA tabled their best practice manual this morning. I just want your comments. Have you followed the processes in this manual in the work that you have done or how is it different? And how do you see the clinical manual that you're currently working on is going to differ from what's in this hefty tome?

Ms Gillespie : I have to say: I haven't seen that, so I couldn't make comment.

CHAIR: Ms Mangan, have you seen—

Ms Mangan : No. The first I heard of it was today.

Senator RICE: It says in the foreword that it's a best practice manual, which is signed by Elizabeth Broderick, the Sex Discrimination Commissioner at the time. It's a significant publication, certainly to be used more broadly than by just Rape and Domestic Violence Services Australia. You haven't previously—

Ms Mangan : No.

CHAIR: So you won't have any comment about how the clinical manual that you're working on is going to compare with what's in here?

Ms Mangan : I would imagine that a lot of it would align. The models are fairly similar around the world—the practice and the acknowledgement around trauma and the response to trauma. It's fairly consistent around the world. It's not that they're doing it differently in the UK to Australia. We're generally all following the same model. We listen and learn from each other. I would say that we would imagine that, if we were dealing specifically with cases of trauma, you probably couldn't get a better manual.

Senator RICE: Have you had a similar manual in the past for the work that you've done in cases of trauma?

Ms Mangan : Yes—certainly not to the extent of that but comprehensive enough. It's not a prescription for our counsellors, because they come professionally qualified as well. There are also policies and practice standards that they follow. The other thing that's very important is the clinical supervision that they are provided on a very regular basis. That actually hones their skills as well. The other thing that's very important to remember is that we are all feminist services. We all operate under a gender analysis of domestic violence. Therefore, that dictates a lot of our framework and how we see it. So we don't think in clinical, medical terms.

Senator RICE: Would you be able to table the manuals that you have been using until now, or the equivalent of this?

Ms Gillespie : Our practice manuals?

Senator RICE: Yes, your practice manuals.

Ms Mangan : Yes—absolutely.

Senator RICE: Thank you.

Senator KAKOSCHKE-MOORE: One of the concerns or criticisms that have been levelled at the new model is the ability for counsellors employed under the new panellists to work from home, and there are concerns around how to manage vicarious trauma, particularly for those who might be living with the worker. Can either or both of you talk to the committee a little bit about whether you will allow your counsellors to work from home and how you will manage that? I see some shaking heads, so that's a start.

Ms Gillespie : No. We wouldn't subscribe to any of our counsellors working from home. We've been very clear with Medibank about that. That was part of our negotiations in the contract—that we wouldn't concede to that.

Ms Mangan : Not only that. We certainly agree with others around the triage model being operated from home. We are not supportive of that either.

Senator KAKOSCHKE-MOORE: Thank you. That clears that up.

Ms Mangan : There's more for us to say on that score with Medibank. It's a developing process, but we have a great concern: for the calls that come to us, we want to know what came first; we want to know where they went.

Senator RICE: Could you expand on that? Are there further issues that you have with Medibank over the triage model?

Ms Mangan : I think they've been very receptive. We're not forcing the issue; we're trying to get our ducks in our row around the tertiary side of the service model. Once we do that, as we have forecast already to both Medibank and the department, we would like to examine the triage model and we would like to make some changes.

Ms Gillespie : safe steps has been vocal for many years about the model being delivered by one service and one state and then, subsequent to the triage model coming in place, has been critical that that is not being delivered by family violence specialist services. We were very vocal in the KPMG report, and it's a matter of public record.

Senator KAKOSCHKE-MOORE: I want to make sure I understand your positions correctly. Are you supportive of the triage model?

Ms Mangan : Yes.

Senator KAKOSCHKE-MOORE: But you have some concerns around how MHS is operating its first responder portion of the model?

Ms Gillespie : Yes.

Ms Mangan : My concern over the years has been that 1800 RESPECT is the number at the bottom of every news article, and the assumption is that it's a hotline. So it had been our concern for a number of years that there be some message, when on hold, to say, 'If you're in crisis and you're from Queensland, ring this number,' or introducing some model. DV Connect introduced a triage model about three years ago, so we have a process—and I understand that safe steps is the same. There's a team of triage councillors who manage that part of it, followed by the crisis counsellors, followed by the placement counsellors. I'm a great supporter of using what means you have professionally, provided you're not jeopardising safety, and that's the most important thing—that we do that. I think the good thing about the triage model is that it allows you to look at the numbers and you can then decide that you can't triage for the next half hour, because you have obligations to the calls that have come through. It allows you to move with the demand or your commitment to how you need to respond to that. That's part of what we do every day. It's a living organism.

Ms Gillespie : What we are not supportive of is the triage being delivered by counsellors from their home. That's what I want to be clear about.

CHAIR: Is it your understanding that there are overflow arrangements that see some of the calls directed to other parts of the MHS call infrastructure? We've had reports that they might be diverted to, say, the Quitline or—

Ms Gillespie : I've heard those reports, but I don't have any evidence that that's the case.

Ms Mangan : We would have a problem with that.

Ms Gillespie : We'd be very vocal about that.

Senator SINGH: I want to ask, as you are different organisations, how the governance structure works. You obviously have separate boards, but you are now both operating the 1800RESPECT service. How does that work in the sense of your own specific organisations? Is it an agenda item for your meetings? Is it reported? What is the independent structure of that and how then does that come together as part of meeting your obligations under MHS's arrangement?

Ms Gillespie : I can speak for safe steps. Ms Mangan might have a different view. For us it's a program of service that we deliver. We have crisis intervention programs and we have the family support programs and courts et cetera, and 1800RESPECT is a program that is delivered out of our service. So, yes, it's reported against at board meetings. It's reported against at executive meetings. There are internal meetings across the organisation of key components of the program that come together. Then there is the Medibank Health Solutions and partners clinical governance group, which hinges it together.

Ms Mangan : Yes, we all agreed at the beginning that these would be services within a service. They'd be separate services. They are different programs. The crisis counsellors are not taking these calls in between other calls. These are dedicated counsellors.

Senator SINGH: I'm trying to get a snapshot across the country of how this is all broken up now.

Ms Gillespie : It's not broken up from the clients' perspective. They still ring one number and they are referred—

Senator SINGH: But it could be a different organisation, depending on where they are.

Ms Gillespie : Yes. They are referred to who is on shift at that time.

Ms Mangan : Medibank, through their workforce planning, along with us, have a lot of teleconferences—particularly more so now, but they are planned to be daily—around the rostering, as to the demand. We will all have a roster for a certain period of time so each service will know at what times they're putting counsellors on.

Senator SINGH: And that's 24 hours?

Ms Mangan : Yes.

Ms Gillespie : We run 24/7 services anyway, so we've already got special services.

Senator SINGH: This may be a premature question, but on the funding side, how do you see the current funding provision?

Ms Mangan : The federal funding is very generous compared with state funding. The funding to our services has allowed an extra injection of training and professional development.

Senator SINGH: You haven't put on extra staff?

Ms Mangan : We put on all the staff they have wanted us to put on. I think we're looking at the growing trend. Is this a growing trend? Apparently the calls are getting higher, so it's a day-by-day process. But at this point in time, when you compare state funding with federal funding, we are satisfied.

Ms Gillespie : To be clear it's a unique program within our service, so we've recruited for that program. It's independent of the other services we deliver through our state funding.

CHAIR: Ms Mangan and Ms Gillespie, that's probably all the time that we have. We're very grateful for you travelling here today. I gather both of you must have travelled to be in Sydney, and we appreciate you doing that. There may be follow-up questions from committee members and, if so, the secretariat will be in touch. Thanks very much.