Commissioned by FaHCSIA, the ANCD sought input from the AOD, FS and CP sectors on how best to refocus the Strengthening Families Program after the announcement by the Minister for Families, Housing, Community Services and Indigenous Affairs, the Hon Jenny Macklin, that the $3.1 million annual allocation for the Program be used to provide parenting and substance misuse support where children are at risk. In particular, views were collected about the most appropriate service models, programs and investments that could be made with the announced change in focus. The consultation involved an online survey of interested workers in the AOD, FS, and CP sectors and structured telephone interviews with key state and nationally focused AOD, FS and CP bodies.
Limitations
When interpreting the key findings of the online survey and the phone interviews, it is important to be aware of a number of limitations with the consultation. These relate to the sample, the use of set optional response questions asked in the online survey, the number of organisations involved in the telephone interview component of the consultation, and the timeframe and resources available for the consultation as a whole.
A total of 171 responses to the online survey were included in the final results. Most respondents were from FS and AOD services, and consequently, the views of individuals working for CP services may not have been represented in the final results to the same extent as the FS and AOD respondents. In relation to the questions asked in the survey, they required a set response. While opportunity was provided for respondents to provide additional comments in a number of questions, these comments were not generally directly relevant to the specific questions being asked or related to the annual budget of $3.1 million. Consequently, much of the additional qualitative information obtained from the online survey was either not relevant to the consultation process or was not feasible within the budget context of the program and could not contribute to the findings.
Responses also generally indicated sector support for furthering service delivery in their own sector. This is likely to be a mix of better knowledge of that sector, and a better understanding of how this could be done rather than necessarily mere self-interest. A more detailed analysis of the results might have been able to elucidate the extent to which each sector was supportive of specific suggestions in other sectors but time constraints did not allow for this.
Analysis
The information obtained from the online survey provides a good understanding of what respondents from the AOD, FS and CP sectors consider as the priorities when selecting the most appropriate service models and programs for the refocused Strengthening Families Program. Difficulties with access to services, including waiting lists, the lack of experienced multi skilled staff and inconsistencies with linkages and collaboration between the sectors were also noted as being important issues needing to be addressed if the best outcomes for families affected by substance misuse were to be achieved.
Both the expansion of existing AOD service providers to address the needs of people affected by substance misuse who may have children and the development of a program to enable existing AOD, FS and CP services to become better equipped in identifying children at risk in families affected by substance misuse were selected as the preferred choice of service model. The inclusion of aftercare support for families with members who have undergone AOD treatment/intervention, early identification and prevention; treatment/intervention; case coordination between AOD, FS, and CP services; referral between sectors ; and outreach services were all identified as important services required for achieving the best outcomes for families and children at risk.
Some of the respondents noted that $3.1 million was a relatively small amount for a national program and therefore significantly limited their vision or suggestions while others who are not familiar with national funding programmes would not have been aware of the potential amounts this might mean for any particular jurisdiction and/or service and the implications of this. Support for a few of the service models differed depending upon the specified annual budget (not reported here). Generally, when asked about their support for service models within the context of an unlimited budget, more people found individual service providers and one stop shops appropriate compared with an annual budget of $3.1 million.
The telephone interviews provided specific information in terms of the issues and potential service models, services, and initiatives that are pertinent to refocusing the Strengthening Families Program. However, a total of only nine organisations were initially contacted to be involved in that component. Due to resource and time constraints, one of the key national AOD peak bodies was unable to take part resulting in a state peak AOD body being invited and interviewed. Notwithstanding this, additional information was able to be obtained from the phone interviews that complemented the information obtained from the online survey.
Issues with identifying and responding to children at risk were also noted during each of the phone interviews. Although each sector saw this as a priority, the AOD sector in particular, was noted as not being as skilled or in a position to be able to identify and respond to children at risk. This situation within the AOD sector is often identified as being due to funding not extending to include family related services.
Most AOD services are paid to deliver specialist AOD specific interventions to individuals who are misusing alcohol and other drugs. It is not surprising therefore that they struggle to extend their resources to attending to families and even more, to children in families. They all recognise that this is important work and that it is a significant part of successful intervention in the longer term and also a specific preventative intervention for the next generation of Australians. However, they are only funded for direct work with the alcohol/drug user and a broader remit requires additional resources. In this context the Strengthening Families Program funding has been almost the only source of funding for such extended and holistic responses.
If the needs of children at risk are to be prioritised then the focus for the new Strengthening Families Program would be best directed towards improving the skills of workers in the AOD and FS sectors in identifying and responding to children at risk. Although services across the sectors were identified as generally being clear about their statutory obligations, there were a number of important issues that need to be taken into account.
A number of services were identified as not having the skills and resources to deal with the complexity of identifying and responding to issues of substance misuse and children at risk. In particular many were unclear about the meaning of risk and lacked an understanding of the different levels of risk and the best ways of responding to these different levels of risk.
These issues around identifying and responding to children at risk were particularly evident in the AOD sector. In the FS and CP sectors, an understanding of risk, and tools in which workers are trained exist however, the lack of understanding about AOD-related risks for children and families among the FS and CP sectors, combined with a general lack of awareness about risk in the AOD sector, indicates that there may be a need to clarify, specifically, what is meant by AOD-related risks for children and families so that there is a shared understanding of what constitutes risk and the implications of this between the three sectors. Problems within the FS sector around identifying risk within the context of a family affected by substance misuse were also noted. One method of addressing this is to have a common set of instruments that all three sectors are familiar with.
No one sector was identified as being the ideal one to be primarily responsible for ensuring that families access all of the services they need but rather the importance of services being able to respond to the multiple needs of families was noted. It is therefore important that services within the three sectors develop effective, locally relevant partnerships and liaison arrangements with one another. Currently this does not occur uniformly between the sectors. However, a ‘no-wrong-door’ policy approach would be appropriate in these circumstances.
The development of partnerships and liaison arrangements between the three sectors could include development of memorandums of understanding or other arrangements that allow for clear articulation or roles and responsibilities and ways of working and communicating. These arrangements could also assist in resolving the tensions that exist within AOD services and any other complex issues such as data sharing.
If the funding allocation prevents improving the skills of workers across all three sectors then it would seem most appropriate that the focus be placed on the AOD sector. This is based on the identified need and the overall support for the expansion of existing AOD services, particularly from FS services. This was despite there being a bias in responses towards supporting initiatives which expanded or involved respondents’ own sectors. In addition, funding from within the overall FSP could allow for FS and CP services to be developed in this respect.
There was a general impression that respondents to both the online survey and the telephone interviews were heavily influenced by a focus on short-term initiatives. Specifically, strong support for service delivery initiatives and lack of support for infrastructure, IT, and organisational development indicate that respondents were focused on short-term outcomes rather than on methods of building the response to implementing a medium to long-term strategy to identify and respond to children and families at risk of AOD-related harms.
The lack of support for infrastructure and organisational development did differ with the AOD sector where there was general support for funds to be allocated on strengthening the sector. This response is not surprising as it reflects the overall needs of the sector and highlights the need for a closer examination of such things as organisational governance arrangements, qualifications and levels of staffing.