Consultation Report 

The main findings of both parts of the consultation are presented in nine sections, representing important themes or components. These are:

1. Service Models
2. Program Design
3. Criteria for Selecting Programs and Services
4. Criteria for Selecting Providers
5. Targeting Particular Groups
6. Respondents’ Final Comments
7. Linkages and Collaboration between sectors and services
8. Improving Access to Relevant Services
9. Identifying and Responding to Children at Risk

The first six sections cover information obtained from the online survey and the last three cover information obtained from phone interviews only. These sections inform the development of the most appropriate service models, programs and investments that could be made within the context of the Family Support Program and the National Framework for Protecting Australia’s Children to provide the best outcomes for families affected by substance misuse. Responses for each sector were examined to determine whether meaningful differences existed. When this was deemed to be the case, results for all three sectors are presented at the end of each section under a subheading entitled Variations by Type of Service.

1. Service Models

Respondents answered two questions related to potential service models. Respondents were asked to indicate how appropriate a number of specified service models would be to achieve the best outcomes for families and children at risk within an AOD context and the current national annual budget of $3.1 million. Figure 4 depicts the results of this question for each proposed service model according to the level of appropriateness.

There was general support for a number of proposed service models including expanding existing AOD or FS and CP services and developing new programs to allow AOD or FS and CP services to identify and respond to children at risk. There was a general lack of support for a single service provider to roll out standardised programs and the establishment of one-stop shops.

 

Description of Figure 4

Figure 4.  Appropriateness of potential service models.

 

• More respondents (70%) indicated that expanding existing AOD services to address the needs of clients with children was very or extremely appropriate than any other proposed model.
• Two thirds (66%) of respondents indicated that developing a program to enable existing AOD service to better identify and respond to children at risk was very or extremely appropriate.
• Approximately 60% of respondents indicated that developing a program to enable existing FS and CP services to become better equipped to identify children in families affected by substance misuse was very or extremely appropriate.
• More than half of respondents (56%) indicated that a number of individual services situated across Australia providing services which meet local needs was very or extremely appropriate.
• Nearly 61% of respondents indicated that expanding FS and CP services to address substance misuse in families was very or extremely appropriate. Approximately 12% indicated this was not appropriate.
• More than half of respondents (56%) indicated that a program of funding which follows individual children across AOD, FS and SP services were very or extremely appropriate. Nearly 13% indicated that this was not appropriate.
• Approximately 41% of respondents indicated that a number of one-stop shops located in key areas providing a range of services was very or extremely appropriate. Approximately 24% indicated that this was not appropriate.
• Overwhelmingly, the proposed model involving a single service provider to roll out a standardised program across Australia was not supported, with only 10% indicating that this was very or extremely appropriate. More than half (58%) indicated that this was not appropriate.

Variation by Type of Service

A number of responses differed substantially between sectors.

Generally, the results indicate sector support for furthering capacity in their own sectors with the exception of expanding FS and CP services to address substance misuse issues where the least support came from FS services.

• The strongest support for expanding existing AOD services to address the needs of people affected by substance misuse who also have children came from AOD services where 79% indicated this model was very or extremely appropriate. This compared with 63% for FS and 59% for CP services.
• The strongest support for expanding existing FS and CP services to address substance misuse came from CP services (79%). This compared with 61% for both AOD and FS services. FS services were the most likely to indicate that this was not appropriate (14%) compared with AOD (13%) and CP services (7%).
• The strongest support for developing a program to enable existing AOD services to become better equipped in identifying and responding to children at risk came from AOD services where 77% indicated this would be very or extremely appropriate. This compared with 69% for CP and 61% for FS.
• The strongest support for developing a program to enable existing FS and CP services to become better equipped in identifying children in families affected by substance misuse came from CP services where 73% indicated this would be very or extremely appropriate. This compared with 62% for AOD services and 57% from FS services.
• The greatest support for one-stop shops came from CP services (52%); of respondents indicated this service model was very or extremely appropriate. This was in comparison with 41% for FS services and 33% for AOD services.

Key Findings

Most supported

• The expansion of existing alcohol and other drug service providers to respond to child and family issues
• The development of a program to enable existing AOD, FS and CP services to be better equipped to identify children at risk in families affected by substance misuse were identified as the most appropriate service models to achieving the best outcomes for families and children at risk.

Least supported

• A single service provider to roll out a standardised program across Australia was identified as the least appropriate service model to achieving the best outcomes for families and children at risk.

2. Program Design

Respondents were asked to indicate how important a number of specified services would be to achieve the best outcomes for children and families at risk. Figure 5 presents the results of this question.

There was strong support for all services with the exception of a national marketing campaign.

Description of Figure 5

Figure 5.  Appropriateness of potential services.

 

• The strongest support was for aftercare support where only one (0.6%) respondent indicated that this was not appropriate and 90% indicated that this was very or extremely important.
• Approximately 90% indicated that early identification and prevention were very or extremely important.
• Approximately 88% indicated that treatment/intervention very or extremely important.
• Approximately 88% indicated that case coordination between AOD, FS, and CP services was very or extremely important.
• Approximately 86% indicated that referral between sectors was very or extremely important.
• Approximately 81% indicated that outreach was very or extremely important.
• Fewer than half (43%) indicated a national social marketing campaign was very or extremely important and 12% indicated that this was not important.

Variation by type of service

There were not generally substantial differences in responses according to the type of service respondents worked for.

The one exception was for case coordination between AOD, FS, and CP services. For this initiative, strongest support came from CP services.

• Almost 97% of CP services indicated that this would be very or extremely important. This compared with 91% for AOD services and 84% for FS services.

Key Findings

Most supported

• 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 identified as the most important services to achieve the best outcomes for families and children at risk.

Least supported

• A national social marketing campaign was seen as the least important service to achieve the best outcomes for families and children at risk.

3. Criteria for Selecting Programs and Services

Respondents to the survey were asked to indicate how important a variety of services should be when considering allocation of funding under the Strengthening Families Program. Figure 6 presents the results for each proposed service and program according to the level of importance indicated by all respondents.

Strongest support was for direct service delivery initiatives (service delivery) and the least support was for IT infrastructure.

 

Description of Figure 6

Figure 6.  Importance of services when considering allocation of funding.

 

• Almost 96% of respondents indicated that direct service delivery initiatives were very or extremely important.
• Between two thirds and three quarters of respondents indicated that workforce development (77%), information sharing (69%), data collection and analysis (65%), integration of services (62%), and organisational development (62%) were very or extremely important.
• Roughly half of respondents (51%) indicated that sector development was very or extremely important.
• Less than half of respondents (42%) indicated that IT infrastructure was very or extremely important and 26% indicated that it was not important or somewhat important.

Respondents were asked to indicate how important three specified factors should be when determining which programs or projects receive funding. Figure 7 present the results of this question for all three proposed factors according to the level of importance indicated by respondents.

There was general support for all three factors but strongest support was for prioritising responses to disadvantaged populations.

 

Description of Figure 7

Figure 7.  Importance of factors when determining which programs/projects receive funding.

 

• Nearly 81% of respondents indicated that prioritising responses to disadvantaged populations was very or extremely important. This compared with 67% for a research/evidence base for proposed services and programs and 66% for prioritising geographic areas of greatest need.

Variation by Type of Services

Responses differed for a number of proposed initiatives according to the type of services respondents worked for.

Generally, strongest support for organisational development, sector development, and integration of services came from the AOD sector.

• The strongest support for organisational development came from AOD services where 77% indicated that it was very or extremely important. This compared with 60% for both CP and FS services.
• The strongest support for sector development came from AOD services where 61% indicated it is very or extremely important. This compared with 52% for CP and 51% for FS services. The strongest rejection of sector development came from CP services where 17% indicated it would be not important of somewhat important. This compared with 15% for FS and 7% for AOD services.
• The strongest support for integration of services came from AOD services where 67% indicated that this would be very or extremely important. This compared with 57% for FS services and 50% for CP services. The least support for integration of services came from FS services where 25% indicated integration of services is not important or somewhat important. This compared with 23% for CP and 13% for AOD service.

Key Findings

Most supported

• Direct service delivery (service delivery) was considered the most important service factor when considering the allocation of funding under the Strengthening Families Program.

Least supported

• IT infrastructure and sector development were considered the least important service factors when considering the allocation of funding under the Strengthening Families Program.

4. Criteria for Selecting Providers

Respondents to the survey were asked to indicate how important they believed a number of specified factors to be when determining which service providers receive funding under the refocused Strengthening Families Program. Figure 8 presents the results of each factor according to the level of importance.

There was strong support for evidence of current service capacity and performance; ensuring services are located in areas of greatest need, and the likelihood of service sustainability in the medium to longer term.

 

Description of Figure 8

Figure 8.  Factors to consider when determining which service providers receive funding according to importance

 

• The vast majority of respondents indicated that evidence of current service capacity and performance (89%), likelihood of service sustainability in the medium to longer term (88%); and ensuring services are located in areas of need (86%) were very or extremely important when determining which service providers receive funding. The strongest support was for considering current capacity and performance where no respondents indicated that this was not important.
• A majority of respondents indicated that rationale and relevance to the refocused Strengthening Families Program (70%) was very or extremely important.
• Sustaining the existing services currently funded under the Strengthening Families Program (58%) was seen as very or extremely important.
• Fewer than half of respondents (47%) indicated that maintaining continuing funding for other existing services were very or extremely important.
• Half of respondents (52%) indicated that whether a service existed within a larger organisation was not/only somewhat important when determining which service providers receive funding.

Key Findings

Most supported

• Evidence of current service capacity and performance, likelihood of service sustainability in the medium to longer term; and ensuring services are located in areas of need were considered the most important factors when determining which service providers receive funding under the refocused Strengthening Families Program.

Least supported

• Whether existing within a larger organisation was considered the least important factor when determining which service providers receive funding under the refocused Strengthening Families Program.

5. Targeting Particular Groups

One hundred and twenty nine respondents to the survey provided information about particular client groups which should be targeted as a priority. Figure 9 presents a summary of the main disadvantaged populations and geographic areas identified in these responses.  The bolded terms refer to the general population or area into which responses were grouped. Bulleted points refer to specific characteristics identified by respondents in their responses.

The greatest number of comments related to Indigenous populations (54 comments) and vulnerable families (50 comments).

Disadvantaged populations

Geographic areas

Indigenous Young women Families At risk children and families Identified by government-based child protection services Not identified by government-based child protection services Vulnerable Families Parents leaving prison Young parents Pregnant women Children with AOD issues Parents with AOD issues Multiple and complex issues Dual diagnosis Domestic violence/ sexual abuse Youth Adolescents Children

Disadvantaged communities Concentrated socio-economic disadvantage High proportion speaking a primary language other than English Regional, rural, and remote Geographically distant from services Indigenous communities

Figure 9.  Main populations and geographic areas identified as priorities by respondents.

 

Key Findings

Most supported

• Prioritising responses to disadvantaged populations was identified as being the most important factor to consider when determining which programs/projects receive funding. These populations included Indigenous people, at risk children and families, vulnerable families, people with multiple and complex issues, and youth.

6. Respondents’ Additional Comments

In addition to the quantitative responses in the survey, respondents were provided an opportunity to provide final comments on issues they believed relevant to refocusing the Strengthening Families Program.

The primary theme which emerged from these responses was the need to tailor services to meet the needs of specific client groups and geographic locations.

Many of these groups and geographic locations were those identified in figure 9, above. Repeatedly, Indigenous populations and rural and remote communities were identified as needing to be the priority for the Strengthening Families Program. Emphasis was placed on culturally appropriate services and the need to use existing services to refocus the Strengthening Families Program rather than develop new initiatives.

Key themes from additional comments
Tailoring services Specific Groups Indigenous populations Geographic locations Regional, rural and remote Culturally appropriate services Expanding existing services Continuity of service Holistic approach to service delivery Underlying causes of abuse and neglect

In addition to tailoring services to specific groups and geographic locations, many respondents emphasised the need to promote continuity of service for individuals, especially children, involved in AOD, FS, or CP services. A number of respondents identified a holistic approach to strengthening families and responding to the risk of substance misuse in a family with children. Some respondents indicated that this could be achieved by addressing the underlying causes of parental neglect and child abuse.

7. Linkages and Collaboration Between Sectors and Services

Greater emphasis needs to be placed on linkages and collaboration between the sectors and service if appropriate referral between the sectors is going to improve.

Key issues from telephone interviews (linkages and collaborations)
Greater emphasis on linkages and collaborations needed to facilitate appropriate referrals Current linkages and collaborations vary by service and sector Usually contingent on individual staff and services Services within larger organisations link and collaborate more often

When asked to provide additional information on the linkages and collaboration between sectors and services, respondents from the phone interviews indicated that the level of linkage and collaboration between the AOD, FS and CP sectors and services varied and was generally dependent on individual staff and services. Where services were part of a larger organisation that provided a range of services across the sectors or where states required inter service and inter sectoral partnerships, stronger linkages and collaboration were noted to occur.

Particular issues identified as impacting on the ability of services to link and collaborate well with one another included:

• Competing work demands
• Lack of knowledge about other services, particularly between the different sectors
• High turnover of staff
• Funding agreements not including this aspect of service delivery
• Confidentiality issues, particularly with CP services.

Suggestions on how linkages and collaboration could be improved included:

• A top down approach to the Strengthening Families Program that includes an interdepartmental approach and requirement for service agreements to include the establishment and use of memorandum of understandings between services and sectors
• Provision for financial incentives supporting linkage and collaboration between the sectors
• Provision for worker incentives.

8. Improving Access to Relevant Services

The importance of families being able to access a range of services at any one time was noted as being important in ensuring the best outcomes for families and children at risk. This however was not necessarily required to be available at the one place.

Key issues from telephone interviews (improving access to relevant services)
Families being able to access a range of services is important All three sectors indicated:  long waiting lists are a barrier accessing CP services was complicated by focus on risk management AOD sector indicated: limited residential services for mothers with children inadequate services for pregnant women FS sector indicated: families unable to access AOD services

Issues with access were identified during most of the phone interviews with all three sectors noting the existence of waiting lists. This was particularly evident where clients had multiple issues and were seeking assistance as a family unit. For example within the AOD sector there were limited services, particularly residential services were parents or pregnant women were able to receive treatment for their AOD issues whilst also looking after their children. Likewise families accessing FS services were often not able to obtain the assistance they needed to address AOD issues. Access to CP services was also noted as being quite difficult and off putting to clients due to the focus on risk management issues.

Additional issues identified as creating barriers to clients and other services accessing services included:

• Insufficient funding, including capital works funding to provide appropriate facilities
• Little scope within funding agreements to provide a range of services
• Lack of experienced, multi skilled staff
• Little public awareness of available services
• Perceived stigma of seeking help was also noted as a barrier for clients, resulting in many families not accessing services until they were in crisis.

Most responses to the telephone interviews indicated that all three sectors should theoretically be able to be the initial point of access for clients and that many services were seeking to cater more broadly to the needs of families affected by AOD issues. 

Suggestions on how access to relevant services could be improved included:

• Funding to support the provision of case coordination
• Funding to support an increase in services that cater to the needs of families affected by AOD issues.

9. Identifying and Responding to Children at Risk

All sectors saw identifying and responding to children at risk as a priority for services with many reporting that they were aware of their statutory obligations.  Services dealing more directly with children and families were generally noted to be more skilled in being able to do this while other services, particularly AOD services were noted to be generally not as skilled. Most respondents however highlighted that identifying risk is a complex issue with some services often not being good at recognising and dealing with this complexity. There was a significant level of commentary regarding the need to clarify what is meant by the term ‘risk’ and identifying the appropriate point to refer the family onto child protection services. It was also noted that it was important for staff to recognise that the presence of AOD use did not automatically equate to children being at risk.

Key issues from telephone interviews (identifying and responding to children at risk)
Priority in all three sectors because of mandatory reporting requirements AOD sector least skilled in this area Identifying risk is complex Need to clarify the meaning of ‘risk’ in the context of AOD issues Examples of risk assessment tools exist Staff unskilled in dealing  with families where child is at risk

It was noted that there are a number of good assessment tools available to assist in the identification process but that there is a need for staff to be skilled in using these tools and being able to respond appropriately once identification was made. Staff were also identified as often being inexperienced and lacking in skills to know how to approach people when there are issues of this nature to be addressed.

Components reported as enabling services to identify and respond to children at risk included:

• Development of information that provides a clearer understanding of ‘at risk’ and the levels of risk and how services can best respond to each of these levels
• Training of staff to be able to identify and respond to risk
• Development and dissemination to AOD services of policies and procedures on identification and response to children at risk
• Dissemination to and training of staff on assessment tools for identifying children at risk

Most respondents involved in the phone interviews also emphasised the need for services that responded to the specific needs of individual children. Many of the services being provided were described as addressing the issues of the parents or of the family as a whole but not of the individual children. There is therefore a need for:

• Funding to support the provision of services that cater to the specific needs of individual children.

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