Audio transcript: After the Intervention: The ongoing challenge of ensuring the safety and wellbeing of vulnerable children in the Northern Territory

CFCA webinar - 21 November 2013

Scott

First of all I'd like to say good afternoon, and welcome to this special event from Child Family Community Australia information exchange. The event: After the Intervention: The ongoing challenge of ensuring the safety and wellbeing of vulnerable children in the Northern Territory. My name is Debbie Scott and, and I'm a Research Fellow at CFCA and the Institute of Family Studies. I'd like to begin by acknowledging the traditional custodians of the land on which we are meeting. I pay my respects to their Elders past and present, and to Elders from other communities who may be participating today. I'd also like to welcome our virtual audience who have tuned in from various places around the country as well as those of you who are here in the Balluk Room.

This event is hosted by CFCA Information Exchange but it's being held in conjunction with the Knowledge Circle. Knowledge Circle is a new online resource that shares stories of 'what works' to deliver positive outcomes and to keep Aboriginal and Torres Strait Islander children safe and happy in their communities. More information about the Knowledge Circle will be sent out to you after the presentation. For those of you who are here in the room there is a flyer on your seats.

Firstly Ken's asked me to let you know that those of you accessing this remotely will be able to submit questions via the chatbox during our presentation. There will be a limited amount of time in which Howard can respond to your questions at the end of the presentation but we'll try to get through as many as we possibly can. Also, the session is being recorded and questions will be recorded but won't be uploaded to the website afterwards. And some quick housekeeping, the bathrooms are located through the lift lobby and I'd like to remind you all to switch your phones to silent please.

So now I have the pleasure of introducing our speaker, Dr Howard Bath. Dr Bath has worked as a practising clinical psychologist, agency director, trainer and researcher in child and family services. He has a particular interest in services for children and young people with high needs in the child protection and juvenile justice systems.

Dr Bath has been the Northern Territory Children's Commissioner since June 2008. In this role he has a particular focus on the safety and wellbeing of vulnerable children and families, a majority of whom are Aboriginal and living in camps or very remote communities. In 2010 Dr Bath was the co-chair of an enquiry into the child protection system for the Northern Territory which produced the Growing them Strong Together report. Today Dr Bath will talk about the ongoing challenge of ensuring the safety and wellbeing of vulnerable children.

Please join me in giving him a warm welcome.

Bath

Thank you very much Debbie for that introduction and good afternoon everyone here and in cyberland.

I'd first also like to acknowledge the Wurundjeri people of the Kullin nation, the Traditional Owners of this land here in Melbourne and the many people and places across Australia which are being linked by this webinar.

My job description as outlined in the Care and Protection of Children Act (NT) is to ensure the wellbeing of vulnerable children’ – in a sense I will be going through the KPI’s today.

It’s now been six years since the publication of the Little Children are Sacred report, and the NT Intervention which was the federal government’s response; this was followed by an official NT government response called Closing the Gap NT (not to be confused with the current COAG Closing the Gap policy initiatives).

You may remember that there had been some publicity about horrific cases of child sexual abuse and in particular, a Lateline program that generated a significant public response, followed by dark tales of paedophile rings and the like. The NT government announced it would conduct an Inquiry into the protection of Aboriginal children from sexual assault which later produced the Little Children are Sacred report. Around six weeks after this report was handed to the then NT government, the Commonwealth Government announced the NT Emergency Response, stating that the NT government had failed to ensure the protection of children and to act on the report.

I’m sure you will all have opinions about the Intervention – it formally ran for five years to mid-2012 and cost in excess of $2 billion. The focus of the Intervention was on the prevention of the sexual abuse of Aboriginal children, but the actual intervention targets were broader and aimed at addressing a range of safety and wellbeing issues including community safety (things like alcohol restrictionsnight patrols,women’s refuges). There were new measures covering law and order, school attendance, child protection, health, economic participation, and even land tenure.

The most controversial measures related to the suspension of the Anti-discrimination Act (now re-instated), the compulsory acquisition of leases (now ceased) and the various income management strategies which do continue in various forms.

The $3.4 billion Stronger Futures strategy got underway in mid-2012. SF, in the words of the Commonwealth Government, is the ‘Government’s new commitment, over 10 years, to work with Aboriginal people in the Northern Territory to build strong, independent lives, where communities, families and children are safe and healthy’ (FaHCSIA, CTG Monitoring Report in the NT, Jan-June 2012).

Stronger Futures still carries some of the opprobrium that was attached to the Intervention, although most of the controversial measures are no longer in place or have been modified. Around 2/3 of all the current expenditure is on the provision of services to very remote areas and town camps including teachers and schools, extra police, health workers, more alcohol treatment services, child protection workers, mental health counsellors, night patrols etc.

What has changed for children in the NT?

So, what has changed for the children in the NT and how could we describe the current state of wellbeing and safety for vulnerable children? Rather than a comprehensive review I’d like to look at some key indicators, with some emphasis on child protection as that is the arena for which I have formal monitoring functions.

You would not be surprised to know that it is not a very positive picture, although there are some recent indicators that do provide a little cause for optimism.

Data on sexual abuse

The ostensible trigger for the Intervention was the sexual abuse of Aboriginal children. It is intriguing to look at the official statistics and find that there were not that many child sexual offices in the intervention zone to begin with - in 2006-7 before the Intervention, there were 11; in 2007-8 there were 11 again, and in subsequent years there were 11, 12, 12 again and in 2011-12 it was down to 7 (FaHCSIA 2013).

Have a look at these child protection figures on the issue of sexual abuse. First, here are the actual number of sexual abuse notifications and substantiations processed by the child protection authority, DCF:

It seems as though DCF is going to do what it is going to do, irrespective of the number of notifications. That appears to involve a diminishing number of investigations and substantiations.

The next slide looks at the substantiations by maltreatment type.

You can see that the proportion of sexual abuse substantiations has fallen each year over the past 5 years – it was around 15% in 2007-08; now it sits at less than 1%. The actual number of sexual abuse substantiations has fallen from 117 in 2009-10 to an incredible 18 last year.

It is hard to know why this is the case. But I note that a key finding of the Little Children are Sacred report was that sexual abuse is ‘grossly under-reported’ – is the under-reporting getting worse, or is it possible that the underlying rate of sexual assault is decreasing? We just don’t know the answer from the available data.

Here is another time series measure of problematic sexual activity – the number of notifiable STI’s, in this case for children aged 10-14 years.

In the latest data not reported here, these numbers have continued to rise. There is definitely a story here but it very difficult to know what it is. The numbers could represent the vagaries of the formal STI notification system or an actual increase in prevalence. Moreover, we have no idea about the number STI’s that are the result of consensual (albeit reportable) peer activity versus abusive adult activity. Comparative data from other jurisdictions are not available.

My job entails in part, the review of many child protection and youth justice matters. In my experience, the general thrust of the LCSR that sexual abuse is widespread but is not being reported, does hold true, in fact, it is distressingly common. However, all forms of adjudicated abuse, including sexual abuse, are common in areas of concentrated disadvantage and it is difficult to determine just how the numbers in the NT differ from those of comparable areas in other jurisdictions.

So is there or was there an emergency?

I’ve just come across an article by the prominent journalist Paul Toohey, in it he states that ‘the problem was not a culture of rapists in communities; it was and remains one of mass parental alcohol neglect’. This statement, as with any single-factor analysis, is partially correct.

I’ve always felt that the focus on sexual abuse in the NT has detracted from our understanding of the underlying problem. On just about every wellbeing and safety measure (apart from official statistics on sexual abuse) Aboriginal children in the NT are considerably worse off than their counterparts in other jurisdictions. Here is just a sample of the developmental hazards that impact on infants and young children at higher rates than anywhere else in Australia:

Developmental hazards disproportionally faced by Aboriginal children in the NT:

  • Exposure to family violence
  • Teen parenting (carer instability, poverty)
  • Exposure to alcohol in utero
  • Exposure to nicotine in utero
  • Parental use of other substances
  • Poor nutrition
  • Various diseases such as otitis media and anaemia
  • Abuse and neglect

These hazards have a cumulative impact on development and contribute to the following predictable outcomes:

The impact of developmental hazards faced by Aboriginal children in the NT

  • Infant mortality rates 3 times those of other Australian infants
  • Highest child death rates due to injury and accident
  • Lowest school attendance/achievement
  • Highest rate of youth justice incarceration
  • Highest child and youth suicide rates
  • Highest rates of developmental vulnerability

I won’t go through all these in detail but school can often be a protective factor for very vulnerable children. This is a particularly challenging issue here in the NT where school attendance and achievement scores in remote areas continue their apparently inexorable decline. Here is just one statistic – attendance rates of enrolled children:

You can see that fewer and fewer children are attending school four or more days each week. If this trend continues education will soon cease to be a protective factor for remote children.

Our rates of developmental vulnerability are not only much higher than for Australia as a whole, they are much higher than those for Aboriginal children elsewhere.

Let me just focus for a minute on the latest AEDI scores. These are particularly telling because they suggest that prior to age 5 a perilous developmental course has been set. How can it be possible that half of all Aboriginal children in very remote areas (where 60% of all NT Aboriginal children live) have multiple developmental vulnerabilities before they enter school? These children, according to Menzies’ Professor Sven Silburn, will need special assistance to succeed in school.

So, the official data on sexual abuse may not be particularly compelling but the overall picture for child safety and wellbeing in the NT continues to be of grave concern.

Glimmers of hope

As a brief aside, there are glimmers of hope in these most recent AEDI data. When compared with the first tranche of the data from 2009, the latest figures suggest that the overall wellbeing of Aboriginal children is improving, and improving at a faster rate than that of other Australians.

The 2009 AEDI data suggested that 46.8% of Aboriginal children in the NT had multiple DV’s, a figure that has now dropped over 8.5% to 38.2%. A closer reading suggests that the improvements are largely centred on urban rather than remote areas.

These latest data do suggest that the significant investment in early childhood health and wellbeing services over the past 6 years, primarily by the federal government as part of the Intervention, may be starting to pay off.

If we look at health data there is also some room for optimism:

There have been marked decreases in certain diseases including infectious and parasitic diseasenutritional anaemia and rates of malnutrition but for other conditions, including respiratory disease, skin diseases, injuries and accidents, there has been little change.

Although I have not charted this, the overall hospitalisation rates for Aboriginal children hover around 240-250/1,000 each year and have not changed appreciably – that is, one in four Aboriginal children are actually hospitalised each year.

Mortality rates for Aboriginal infants have continued to decline although the gap between Aboriginal and non-Aboriginal infants remains much the same because infant death rates have declined across the board.

The developmental impact of trauma and chronic stress in childhood

We are of course concerned about the exposure of children to these early developmental hazards because of what we know about the risk of later chronic disease. But it is increasingly apparent that beyond the risk of chronic disease, the exposure of children to stress and trauma leads to a range of mental health issues, behavioural disorders such as substance abuse, and even criminality.

The research findings are now becoming irresistible. Sandra Bloom, one of the prominent voices in the field, sums it up this way:

Trauma theory proposes that the origin of a significant proportion of physical, social and moral disorder lies in the direct and indirect exposure to external traumaogenic agents. (Bloom & Farragher, 2011, p.123)

Many of you would be familiar with the landmark ACE study in the US which correlated exposure to adverse experiences in childhood with adult health and behavioural outcomes.

I will provide just a brief overview to set the scene for a review of the NT situation.

In the late 1990’s a large American medical insurance company, Kaiser Permanente, realised it had collected a great deal of data on many thousands of individuals from birth and throughout their lives. They engaged researchers to look at a number of issues including the life courses of adults exposed to adverse experiences as children.

They identified some recurring adverse childhood experiences and then plotted the risk of later problematic outcomes.

They determined that there were eight adverse childhood experiences (ACES for short) that frequently occurred in the childhoods of the people on their files.

Adverse Childhood Experiences Study

  • Household dysfunction

    • Substance abuse
    • Parental separation/divorce
    • Mental illness
    • Domestic violence
    • Criminal behavour
  • Abuse
    • Psychological
    • Physical
    • Sexual
  • Neglect
    • Emotional
    • Physical

Later, when it became apparent how significant they were, they added two types of neglect – emotional and physical.

For each of these experiences (ACE’s) that occurred during childhood, a score of 1 was allocated, regardless of the intensity of the experience or the number of times that particular ACE occurred.

What they found was a very strong correlation between the number of adverse experiences (ACES) these children had and a range of later behavioural and social difficulties, as well as physical diseases including life threatening conditions. Here is a small sample of the findingsthat are of relevance to vulnerable children here in the NT and elsewhere:

Source: Adapted from Felitti et al., 1998; Felitti & Anda, 2010.

You can see that there is a strong relationship between the sheer number of adverse childhood experiences and later medical and behavioural difficulties. The more ACE’s in childhood, the more risk. For example, for those with zero ACE’s the lifetime risk of reporting IV drug use was 2.5%; the risk for those with four or more ACEs climbs dramatically to 34% or one in three.

With lifetime history of depression, it has now been estimated that the population attributable (to ACEs) risk is 54% - it is 58% for female suicide attempts.

Consider for a momentthe number of ACEs accumulated by most Aboriginal children across the NT and the health, social, economic and justice implications.

With over 50 studies now on the lifetime impact of ACES, the authors conclude:

‘These findings provide a credible basis for a new paradigm of medical, public health and social services practice…’(Felitti & Anda, 2010, p. 86).

I guess he is suggesting that this research encourages us to focus our intervention efforts on improving toxic living environments, ensuring family and community safety, and helping struggling parents to provide the appropriate support and protection for their children.

Of great relevance to us here in the NT, he also notes the large number of adolescent and adult outcomes involving alcohol dependence, other drug misuse, chronic smoking, eating problems and the like, and goes on to observe that:

‘Many of our most intractable public health problems are the result of compensatory behaviours such as smoking, overeating, and alcohol and drug use, which provide partial relief from the emotional problems caused by traumatic childhood experiences.’(p. 86)

There are now a plethora of recent studies of this ilk from all over the world including Australia, with different population samples, looking at a range of adult outcomes. Much of the recent research moves beyond the mere demonstration of the link, to focus on the combination of ACES that lead to specific risks and on understanding the mechanisms involved.

… and I haven’t yet mentioned the burgeoning literature documenting the deleterious impact of trauma on the developing brain.

Here is a summary of the more immediate or proximal developmental outcomes of exposure to trauma and chronic stress (based on Cook et al., 2005). Exposed children are likely to develop difficulties in the areas of:

Trauma Affects...

  • social skills and attachment
  • biological systems and medical issues
  • regulation of emotions/impulses
  • dissociation
  • behavioural control
  • cognitive functioning
  • self-concept, shame and guilt
  • future orientation

But one of these impacts of trauma stands out – research often points to it as the core outcome – the one you are most likely to come across – the one that tends to cause the most stress and distress. What do think this might be?

Here is what the neuroscientists have identified:

‘The most significant consequence of early relational trauma is the loss of the ability to regulate the intensity and duration of affects’ (Schore 2003, p. 141)

‘At the core of traumatic stress is a breakdown in the capacity to regulate internal states like fear, anger, and sexual impulses’ (van der Kolk 2005, p. 403)

And just to rub it in:

‘Children exposed to repeated episodes of overwhelming arousal ...may never develop their capacity to self-regulate. They may be chronically irritable, angry, unable to manage aggression, impulsive, anxious or depressed’ (Bloom & Farragher, 2011, p. 108).

The most significant impact then, is the loss or impairment of the ability to regulate emotions and impulses in a safe, socially appropriate, and adaptive way. For example, a minor frustration can rapidly escalate into rage; anxiety descends into terror; sadness morphs into overwhelming grief. Add any other dysregulating elements such as alcohol, head injury or group contagion, and the problem is greatly exacerbated.

Just consider for a moment the epidemic of domestic violence in the NT; the general violence in places like Darwin’s Mitchell Street; the pervasive partner violence; the road rage. So much of this reactive and impulsive violence results from the inability to safely manage emotions and impulses. Our hospitals and jails are overburdened with the downstream results of this problem.

In a recent news article the anthropologist Prof. Peter Sutton referring to the tri-state area, was quoted as saying ‘These are hair trigger communities where people fly into a rage in a second…and resorting to violence is the norm.’ (Sutton, 2013)

Exposure to violence in the NT

Of all the developmental hazards faced by children in the NT, I would suggest that exposure to violence is the one that is of most acute concern. It has a devastating immediate impact whilst its pernicious distal effects unfold over the lifespan.

The prominent psychiatrist and researcher Bessel van der Kolk maintains that the most pressing public health issue in the USA today is the exposure of children to chronic violence.

If childhood exposure to violence and fear is such a problem in the wider society how much more of a concern is it in those parts of the NT where the violence is endemic – and where, to borrow Bruce Perry’s apt phrase, so many infants and children are ‘marinated in fear’?

This violence affects both the Aboriginal and non-Aboriginal populations in the NT; for example, there are frequent press reports of violence on the party strip in Darwin. However, exposure of children to violence is much more widespread in areas of acute disadvantage - the remote communities and town camps.

I have to say that I still get shocked and sometimes overwhelmed when I see some of these statistics – please bear with me as I quickly review just a little of the NT data on violence and safety.

First a caveat: Much (but not all) of these data relate to issues affecting the Aboriginal community. There is no time to explore in detail the various reasons for the high levels of violence but they are clearly not intrinsic to being Aboriginal – they largely reflect the overwhelmingly stressful conditions that prevail in many remote communities; the over-crowding, the lack of unemployment opportunities, and poor amenities. These are, of course, also related to colonisation and the historical appropriation of traditional lands, radical changes to roles and lifestyles, the onslaught of new diseases, and relentless challenges to systems of meaning including the marginalisation of traditional law and decision-making.

In addition, the mainstream poisons of alcohol, tobacco, ganga (and gambling) which have always been problematic for a minority, have caused devastation amongst these vulnerable populations.

I apologise if this appears to be another ‘misery index’ but this is the reality of children and families across the NT:

  • Aboriginal people in the NT are twice as likely to be hospitalised for assault as are Aboriginal people in the rest of Australia (AIHW, 2011, p. 24). Clearly then, the rates of violence in the NT have more to do with the specific historic, social, economic, environmental and even geographic issues than they do with Aboriginality per se.
  • The latest (and, as it happens, the last) Closing the Gap report for the Northern Territory reveals that the night patrols which were set up as a first response to violence or potential violence, dealt with over 84,700 incidents in the last 6 month reporting period; a yearly projection of over 160,000 incidents – that is in a target area of around 30,000 adults. (FaHCSIA, 2013, p. 69)

For the women, the numbers are even more confronting:

Violence in the Northern Territory

  • The AIHW tells us that whilst Aboriginal women in the NT make up only 0.3% of all Australian women, they account for 14% of all the female hospitalisations for assault in the entire country.
  • In terms of population risk, the mothers of these NT children are 48 times more likely to admitted to hospital for reasons of assault than all Australian women, Indigenous or otherwise (Source: AIHW, National Hospital Morbidity Database, 2010).
  • In 2009/10 in our numerically tiny jurisdiction, 27 non-Aboriginal women were admitted to hospital for treatment after being assaulted. In the same period and for the same reason, over 840 Aboriginal women were admitted. (Source: AIHW, National Hospital Morbidity Database, 2010).
  • Compared to the rest of the female population in the NT, Aboriginal women are 80 times more likely to be hospitalised as a result of assault.

Those used comparative statistics in this arena of Indigenous disadvantage would be used to rate ratios of 2, 5, or occasionally 10:1, but 80:1 is beyond belief. (Source: AIHW, National Hospital Morbidity Database, 2010)

After a while we start to glaze over statistics such as these. I believe they reveal that the situation is much more serious than the rest of the country realises.

…and it is easy for the human reality to be lost in the numbers. In the majority of the incidents reflected in these statistics, children are present, helplessly observing, experiencing the terror, and learning how relationships work.

How important is safety?

We just need to refer to the work of Bowlby, Erickson and particularly Maslow – it is the necessary foundation for healthy development. The policy focus in overcoming the effects of disadvantage is often on school attendance and performance, NAPLAN scores and the like. But people such as Jack Shonkoff (2011) warn that we need to pay as much attention to protecting the brains of vulnerable children long before they enter school as we do to their performance once they get there.

In my job I constantly read about these issues in case files and hear from a range of service providers. I read case after case in which parents are chronically drunk and violent and hear how young kids picked up late at night by the police on the streets of Alice Springs and other urban centres often plead to not be taken back to their homes because they feel safer on the streets.

I understand that ‘Emergency’ has become a tainted word but what do we call the circumstances that are highlighted by these data? At the very least it is a catastrophe for the women and children. While the national debate about the pros and cons of the Intervention goes on, the human devastation also continues and has barely been checked by the responses so far.

The child protection response

The role of the Australian child protection authorities in addressing the safety and wellbeing needs of children is fast becoming a residual one – restricted for the most extreme cases. As some governments seek to limit the roles of such authorities to statutory intervention in only the more extreme cases, they withdraw from the critically important focus on family support services and the promotion of child and family wellbeing, to a singular focus on immediate safety – even that is not done well as they struggle to keep up with increasing demands. In previous decades we had child welfare departments – now we are seeing child ‘safety’ or ‘child protection’ departments.

With the focus on statutory intervention, the courts have to be satisfied that coercive intervention by the state is warranted and consequently the intervention threshold is high – in the NT it has become absurdly high. If a statutory intervention is not sought or not agreed to by a court, then very little assistance is available for vulnerable families. Even when orders are granted very few services are available outside of the five main centres.

For Aboriginal children in the NT, the child protection substantiation rate for abuse or neglect is now close to the Australian average for Aboriginal children. Just a few years ago it was substantially lower.

Here’s how our substantiation rate for Aboriginal children compares to those for other jurisdictions.

On the basis of proxy indicators of abuse (domestic violence, low economic status, alcohol consumption, etc) it is arguable that the NT substantiation rate should be much higher. For example, look at the data from the ACT, Vic and NSW – how could Aboriginal children in those jurisdictions be considered to be less safe than those in the NT? The numbers clearly have more to do with child protection processes and priorities than the absolute level of need.

Let’s look at protective out-of-home care, provided when it is deemed that a child cannot safely remain with his/her parents.

We can see that for Aboriginal children (who account for over 80 per cent of all placements) the NT has the lowest rate of placement in out-of-home care. We are placing (proportionally) a quarter of the children that are placed in NSW.

I would like to be able to provide a comparative graph of the amount of family support being provided – but there is no valid measure for this or any comparative study that I can cite. What I know is that the level of provision is abysmally low.

What I am also sure of is that there has been a structural under-spend by successive NT governments in child and family services, extending back over many years. The assessments of the Commonwealth Grants Commission and the resultant GST grants are designed to bring NT expenditure on such services up to the national average (using the principle of horizontal fiscal equalisation). We get substantially extra per head of population because of the absolute level of disadvantage and the difficulties in providing services in remote areas.

However, as block grants are provided to the various jurisdictions and they are not restricted in how they allocate finances, the budget provided for child and family services falls far short of what has been assessed as being necessary. In fact, there appears to have been a huge gap between the grant allocations and actual expenditure.

In 2010 the Board of Inquiry estimated that the annual shortfall for child and family services was running at around two thirds of the GST allocation – in the vicinity of 140 million dollars (NTG 2010, p. 228).

I have just one more illustration of the difficult struggle to support and protect Aboriginal children in the NT. My office tracked all children who were substantiated as being harmed in 2010-11 and followed them for 12 months.

Number of Repeat Substantiations within a 12 Month Period
  Number Percentage
Children with a substantiation in 2010-11 1425 100.0%
Children re-substantiated within 12 months 337 23.6%

You may not be surprised to know that of the children whose abuse/neglect was substantiated in 2011-12, 23.6% or nearly one in four of them was re-substantiated as being harmed again within 12 months.

This failure to provide protection is, in my view, due to a number of practice, staffing and resourcing issues, but the outstanding reason is asignificant lack of family support and intervention services, and a lack of suitable out of home care options, including kinship care. There is also, I need to add, a reluctance in some quarters to intervene based on a fear of repeating the discredited removal policies of the past.

The BOI in 2010 recommended a focus on supporting families before the need for statutory intervention – the key recommendation was a re-alignment of expenditure so that in 5 years as much would be spent on secondary and tertiary support as on statutory intervention and out of home care. That is, the focus would increasingly be on ‘upstream’, preventive intervention. This was accepted by the previous government but they were struggling to achieve the goal. The current government has indicated that the NT cannot afford to implement the recommendation – so we are left with the proverbial ‘ambulance at the bottom of the cliff model’ – and it’s a broken-down ambulance at that.

So where to from here?

The crisis in child protection reflected in the re-substantiation rates, the drift of children in care, astronomical staff turnover rates, and falling substantiations in the context of increasing notifications, has contributed to the high level of turnover in the CP department; there has also been a high turnover of CP CEO’s (four in a 12 month period) and Ministers (three in the same period); The crisis has also led to controversial calls for the adoption of Aboriginal children drifting in care.

Clearly there are no magic bullets, but the provision of a suite family support and intervention services to the most vulnerable children and families, has to be high on the agenda.

I am not at all convinced that the provision of family support services would actually solve the child safety dilemma in the NT, but their availability would certainly help in combatting the overwhelming need. In the light of the appalling wellbeing and safety indicators, surely it is a moral imperative for the state (including both the Commonwealth and Territory governments) to take the lead in this process and and do what it can to help families safely care for their own children.

Ironically, in the NT there are actually many services that would fall under the umbrella of family support, but they tend to be concentrated in the urban areas away from the greatest need; they tend to be small, local initiatives dependent for their survival on annual grants; few are evidence-based; they are funded by a myriad of funding sources including numerous NT and Commonwealth government agencies, local councils, land councils, philanthropic trusts, Church agencies, and Indigenous enterprises; and few have meaningful accountability and evaluation requirements – in short, we have a pastiche of offerings reflecting the absence of any strategic approach to targeting, program design and accountability.

…...and it is clear that the Aboriginal communities in the NT are tired of things being done to them, regardless of whether they are well-intentioned or not. The recent Board of Inquiry noted that to be successful any new family support services needed the ‘active involvement of Aboriginal people in all aspects of service development and delivery according to accepted self-determination and empowerment principles’ and ‘geared to building the capacity of local communities to assume responsibility for service delivery over time’ (NTG, p. 223, 224).

In the midst of all this, there are a host of committed child protection, health, education and community support workers as well as a handful of world class programs that are soundly based on the evidence; that are being rolled out in areas of great need; that are being operated by Aboriginal-controlled services or in partnership with local communities; and that are subject to rigorous evaluation. The nurse-home visiting program based on the Old’s model and operated by the Central Australian Aboriginal Congress, is one such stand-out program. Other government operated initiatives (for example, the Department of Education’s Families as First Teachers program) are starting to adopt well-researched approaches such as the Abecedarian model.

So it can be done well; and the improvements in the AEDI and the health outcomes I cited earlier suggest that intelligent, targeted policies and well-resourced programs can produce measurable improvements in health and wellbeing in environments as challenging as those in the NT.

Conclusion

So thank you for bearing with me as I have swept over a range of issues relating to the safety and wellbeing of vulnerable children in the NT. Notwithstanding some hopeful signs, it is not a pleasant picture and the challenges have been stubbornly resistant to numerous well-meaning attempts to intervene over the decades.

The Intervention may have passed unmourned into history, to the relief, no doubt, of many Australians. But I hope that we do not now forget the Aboriginal children of the NT - arguably the unluckiest group of children in this otherwise lucky country.

References

AEDI (2013). Analysis of the Australian Early Development Index 2012 Data Collection. The Department of Education, Employment and Workplace Relations, Commonwealth of Australia, Canberra.

AIHW (2010). Aboriginal and Torres Strait Islander Health Performance Framework, 2010 report. Northern Territory. Australian Institute of Health and Welfare, Cat no. IHW 63, Canberra.

AIHW, National Hospital Morbidity Database (2010). Analysis of the National Hospital Morbidity Database conducted in 2012.

Bloom, S. & Farragher, B. (2011). Destroying Sanctuary: The crisis in human services delivery systems. Oxford: Oxford University Press.

Choi, J., Jeong B., Rohan M. L., Polcari A. M., & Teicher M. H. (2009). Preliminary evidence for white matter tract abnormalities in young adults exposed to parental verbal abuse. Biological Psychiatry, 65(3):227–234.

Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., et al. (2005). Complex trauma in children and adolescents.Psychiatric Annals, 35, 390–398.

Enlow, M., Egeland, B., Blood, E., Wright, R. & Wright, R. (2012). Interpersonal trauma exposure and cognitive development in children to age 8 years: a longitudinal study, Journal of Epidemiology and Community Health, 66, 1005-1010.

FaHCSIA (2013). Closing the Gap in the Northern Territory Monitoring Report January–June 2012 Part Two. Department of Families, Housing, Community Services and Indigenous Affairs, Commonwealth of Australia, Canberra.

FaHCSIA (2011) Northern Territory Emergency Response Evaluation Report 2011. Department of Families, Housing, Community Services and Indigenous Affairs, Commonwealth of Australia, Canberra.

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END OF TRANSCRIPT

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