A snapshot of how local context affects sexual assault service provision in regional, rural and remote Australia
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Regional, rural and remote sexual assault services in Australia face unique challenges in meeting the needs of the diverse populations they seek to support. These issues range from geographical barriers, to meeting specific cultural needs in an appropriate manner. The local context of rural, regional and remote areas in Australia has led to some innovative practices by service providers. ACSSA spoke with six sexual assault services in regional, rural and remote areas to explore local contexts and the ways in which managers and workers solved issues through flexible and innovative approaches.
Issues arising in the provision of sexual assault service delivery in regional, rural and remote areas of Australia are often context specific - relating to the economic features and population diversity of a community, geographic distances and staffing needs.
Services in regional, rural and remote areas develop responses that suggests they are an untapped resource of ideas and innovative thinking.
Local context drives flexibility in sexual assault service delivery yet innovative responses can be translated and adapted for use in other communities.
Sexual assault services in regional, rural and remote communities around Australia face a variety of service delivery challenges over and above those common to their city counterparts. Most sexual assault services, regardless of geography, deal with issues such as inadequate or precarious funding, staff burnout and a lack of community understanding about sexual assault. The additional challenges faced by non-urban services have been well documented (Mason, 2008; Neame & Heenan, 2004; Taylor, 2003-04) and include issues of isolation, lack of privacy for clients and staff, difficulty recruiting appropriate staff, high costs and the need to provide culturally appropriate services to particular groups in their communities (Taylor & Putt, 2007). The local community in which sexual assault services are embedded will often determine how these issues are handled.
The provision of sexual assault services usually involves delivery of crisis support and counselling services, but may in some locations include forensic investigation for the purposes of criminal prosecution. Services may deal with adult survivors of childhood sexual abuse or victim/survivors of more recent abuse. They may be linked in with family violence services, where sexual assault is perpetrated in the family context. There is no set model of service provision for sexual assault services, which are state-based and often operated by community organisations. Service provision models therefore vary across jurisdictions and the organisations running them.
However, the importance of providing coherent and consistent specialist sexual assault services to victim/survivors is outlined in both the Time for Action: The National Council's Plan for Australia to Reduce Violence against Women and their children, 2009-2021 report (National Council to Reduce Violence against Women and their Children [The National Council], 2009) and the subsequent National Plan to Reduce Violence against Women and their Children 2010-2022 (the National Plan) (Council of Australian Governments [COAG], 2012). One of the outcomes of the National Plan (Outcome 4) relates to services meeting the needs of women and their children experiencing violence (COAG, 2012, p. 23). The Time for Action report acknowledges that physical location can act as a context-specific barrier to service provision (see p. 75). Our goal in this Wrap is to outline how some of these barriers are overcome in particular regional, rural and remote locations - including how the provision of services to male victim/survivors may require strategic thinking to tailor services that are specific to men's needs.
For the purposes of this Wrap, the term "context" will be used to refer to features of these local communities that include but extend beyond the physical attributes of a place and that create a sense of commonality and identity within that geographical space. The local context comprises shared values and experiences, such as popular recreational activities, the population demographic and employment opportunities. It also extends to gender relations, or how men and women within a given community interact and the roles they may fulfil in a social or work setting - this can greatly impact on the provision of sexual assault services.
The diversity in a local population can impact the values and traditions of a community and can intersect to create hierarchies about who is included and who is excluded in socially beneficial opportunities. This concept of social exclusion can manifest in a sense of disconnection from the broader community (McDonald, 2011).
The importance of particular local industries may also affect how the town sees itself and organises itself, not only geographically, but culturally - for example, a mining town may be a very different place from a wine and gourmet food tourist town. Cultural differences can refer to how inhabitants speak, think and act in the place they live, as well as the stories they tell about themselves (Sidell et al., 2006). "Culture" can be described as the meanings that give direction to a given way of life. For a community, this includes "values, morals, language, world views and patterns of behaviour of a group of people" (Mueke, Lenthall, & Lindeman, 2011, p. 1). An industry may influence local culture, and therefore the context in which the services operate, but it should also be acknowledged that there may be further cultural diversity when distinct cultural groups live within the community. This diversity of cultural identities adds further complexity to the local context when trying to deliver respectful and culturally appropriate services.
Why are local and cultural context important?
Sexual assault services must operate within their local environments, and context can fuel a need for services to be innovative and flexible. Innovation usually refers to finding a response or solution to a particular problem - in a sense, it is transformation (Parker, 2010). Flexibility in service delivery is highlighted in the National Plan as a tool to be used in meeting the diverse needs of diverse populations (COAG, 2012).
Effective services will recognise the need to respond to a particular issue or overcome a gap in service provision by changing their usual practices (Parker, 2010). Services are embedded within the social, political and economic realities of their communities. In order to be effective, sexual assault service providers must be aware of and work within the constraints and opportunities provided by that local context. Constraints may include, for example, local attitudes that are hostile or indifferent to sexual assault prevention messages, while opportunities may be provided by other aspects of that community such as close collaborative relationships.
This Wrap aims to provide a snapshot of the impact of context on six sexual assault services from regional, remote and rural areas in Australia: how context has provided the impetus for flexibility in the pursuit of better and more effective practice in staffing, removing barriers for victim/survivors to access sexual assault services, and collaboration. This snapshot is not intended to be broadly representative; it instead aims to convey some issues discussed with ACSSA in the course of ACSSA's capacity as a networking centre.
Consultation and analysis
The six services consulted for this snapshot of regional, rural and remote service provision and innovation were from across Australia and included communities that relied on several different economic industries, including mining, tourism and agriculture. There were also services in regional centres that served many outlying communities, each of which would have their own local context. This meant that the services were required to have strategies in place to allow them to respond appropriately.
Box 1 contains details of each of the communities in which ACSSA spoke to sexual assault services.
Box 1: Communities in which services were consulted
This regional centre was about an hour from a state capital. Local industries included tourism and mining (this included local mining and fly in/fly out workers to other mining regions). Being so close to the capital, the sexual assault service had access to metropolitan resources but also serviced smaller towns in the area.
Outback town with large Indigenous population
This town had a large Indigenous population and was a long distance from larger centres or capital cities. The sexual assault service in this town was aiming to provide a specific service relevant to a high number of Indigenous service users, but felt that this wasn't being achieved to its fullest potential with a predominantly white, professional staff.
Backpacker tourist town
The main economic feature of this community was a reliance on tourism, particularly the backpacker/international market. There was a large Indigenous population and a large gap between rich and poor. The story that the town wanted to tell of itself was not the story of social disadvantage or violence - it wanted to reveal nothing that would deter tourists. There was a sense in this town that to "do well" meant not focusing on the negative.
Gourmet food and wine region
This community revolved around a high-end tourism and wine industry. Civic leaders placed great emphasis on directing resources into attracting affluent tourists and maintaining a particular image of the region. There was a clear message that sexual assault is not something that should be talked about or displayed openly as it may affect the exclusive image of the area and alarm tourists.
Fruit-growing and agriculture centre
This centre was a geographically diverse agricultural and horticultural town with a large fruit-growing industry. With a relatively large population, this meant access to services was better than in more isolated communities. The sexual assault service in this community also worked to support outlying towns in the region - which requires a concerted commitment toward providing a continuous service.
Resource-heavy industries were important in this community; particularly mining. This created a "blokey" attitude and culture within the community. There were often newspaper stories about locals' tussles with wildlife and other "blokey" exploits.
How does local and cultural context shape service provision?
The delivery of sexual assault services can be shaped by the location in which they are provided (Green, 2007; Parkinson, 2008). This is particularly true for non-metropolitan communities in Australia, as availability of services can be limited (Roufeil & Battye, 2008; The National Council, 2009) and access difficult if long distances are involved. Mason (2008) argued that "the idea of place is a powerful undercurrent in any discussion of rural Australia" (p. 48), but what defines an area as regional, rural or remote varies considerably in the literature (Sidell et al., 2006).
Lievore (2003) described the differences between regional and rural in qualitative terms: "regional" is used for towns that are urbanised but are geographically distant from major cities; "rural" is often connected to farming and is characterised by "a low degree of differentiation in the social structure" (p. 71). "Remoteness" is basically understood as the situation in which a small population is spread over great distances and with very restricted availability of services (Mason, 2010). These distinctions are useful as they do not attempt to homogenise very diverse areas and people - instead, they highlight the difference between non-metropolitan and metropolitan areas.
Economic features and population diversity of a community
A facet of a community's local context is the dominant industry in that community, such as mining or tourism. This exerts influence over the population, as it can attract people of certain demographic backgrounds to work in the main industry and can also affect the ways in which workers in other industries arrange their time (e.g., timing road travel not to coincide with shift changes at a very busy mine).
How a given population in a particular location reacts and responds to sexual assault victim/survivors and services can be directly influenced by the industry within which they operate. This can be because of the values of the industry or the types of people that are attracted to the work that it provides.
Population diversity can be more intricately interwoven where there are further cultural differences in a community within that local context. For example, there may be differing cultures between those who work in a local industry and others who don't; differences in socio-economic status; different religious beliefs; and linguistically diverse groups. This type of cultural patchwork must also influence how sexual assault victim/survivors seek help and how services work to facilitate that connection (Neame & Heenan, 2004). The importance of attending to diversity is acknowledged in the National Plan, and Strategy 3.3 (COAG, 2012, pp. 21-22) speaks to a need for cultural competence in providing service to diverse populations.
An example of this population diversity is given by a services coordinator:
This place is an interesting creature. There is such a high transience through the tourism work and backpackers. These people have no attachment to the community and the community has no attachment to them. It's a changing population. Then there is a high Indigenous population. Another group are born and bred here and believe they're different from the rest of them all - they are laid back, do not want to make a fuss and here for a good time. So I think what that means in terms of service delivery is: how do you navigate those different populations when there's not one culture? I think trying to find people who are wanting to build their community by acknowledging the problems [such as sexual assault] that need to be worked on is part of the journey of the service.
A manager in another community stated:
There are a lot of blokes here. It's a resource-heavy territory; there's a lot of mining here. It's very male-heavy, male-dominated industries. On top of that there is very little prevention education because it's so new and inconsistently applied. So put that beside the very blokey world of [this place and] the prevention message isn't [getting through].
One worker from the gourmet food and wine community commented:
The Council and all the tourism industry here are trying to attract high-class people to the area. They want to silence any issues that might look derogatory or negative to these high-class tourists they're trying to attract. I've tried to get Council members involved in prevention and other projects but I'm constantly told that it's not good for the image. I've been told that domestic violence doesn't happen in this area.
These comments illustrate how the economic industries relied on by different communities can have an impact on the types of people coming to or staying in the area, and the population diversity that can arise.
Indigenous members of a community
Sexual assault services in communities with a high Indigenous population are dealing with communities that have a history of colonisation and disadvantage (Taylor & Putt, 2007). Because of this, many Indigenous Australians are confronted with complex problems that require multi-faceted support. Outcome 3 of the National Plan deals specifically with the cultural needs of Indigenous communities. The National Plan states that Indigenous communities often experience disadvantage that requires additional responses (COAG, 2012). There are higher levels of poverty, poor health outcomes and family violence in Indigenous communities (Lievore, 2003; Taylor & Putt, 2007). Communities with high rates of violence can mean that many victim/survivors will have experienced repeat victimisation (Tarczon, 2012), and sexual abuse and family violence are linked to higher rates of depression, anxiety and substance abuse (Guggisberg, 2010; Tarczon, 2012).
Services must take into account that these impacts can lead to chaotic lifestyles which, when combined with the distances involved in reaching services, can make it difficult to keep appointments. In addition, factors that can make services less accessible include a lack of culturally appropriate or affordable services, or issues with communication and outreach. Research on service delivery in an Indigenous context acknowledged that, in terms of establishing trusting relationships and utilising local knowledge, it is advantageous to have Indigenous staff in a service (Stewart, Lohoar, & Higgins, 2011).
The National Plan supports the strengthening of Indigenous communities so they may develop "local solutions to preventing violence" (COAG, 2012, p. 20) and this calls for flexibility in the face of unique challenges (Mason, 2010). One solution to the problem faced by clients in getting to appointments was dealt with by the practitioner picking up clients and by the service operating more informally, without the need for structured appointment times.
A practitioner outlined an example:
I pick up mum, I pick up her 12-month-old and I pick up the 3-year-old and head in. Or if you make appointments people will say, yeah, yeah, and then they'll forget and then they're a bit ashamed to come back because they've missed their appointment. So we just say, [come in] whenever you want to drop by. It's more of a drop-in service.
This flexible and inclusive service is evidence of what Fredericks (2010) found in a study of Aboriginal health services, when she stated that "physical sites and appearances of health services can act as social texts that convey messages of belonging and welcome" (p. 10). Creating a sense of belonging and welcome is evident in the response of this service: it has extended an open invitation that acts as an on-going welcome. The physical appearance of a centre may also convey a sense of belonging, perhaps through its location, through displays of artifacts, use of local languages and other activities that acknowledge the local culture of the people.
There is also the broader picture of how these smaller regional, rural and remote services interact with and relate to support services in metropolitan areas or funding bodies that are usually located in major cities. There can be a physical distance as well as conceptual distance between metropolitan stakeholders and the regional, rural and remote sexual assault services (Mason, 2008) in the sense that it can be difficult for those in large cities to comprehend what rural providers are facing if they are not part of the local experience.
As noted by Cheers, Darracott, and Lonne (2007), it is often more difficult for people in regional and remote communities to influence social policy for various reasons, including geographical isolation and a lack of resources.
Regional, rural and remote areas are not all alike, nor are they like metropolitan areas (Cheers et al., 2007; Mason, 2008; Roufeil, Battye, & Lipzker, 2007). Without close consultation between policy developers and staff in non-metropolitan areas, there is a risk that policies developed outside the local context in urban centres not familiar with the local issues may not have resonance in regional, rural and remote areas (Eversole, Brumby, & Jack, 2007; Mason, 2006, 2008).
This disconnect was noted by a manager:
Unless you see it, Aboriginal people hungry and begging, experiencing racism in their own town - see somebody so deeply disrespected - you're not going to be able to know how it is for a young woman who has been sexually assaulted. I know these things are quite philosophical but they do link back eventually to the response to sexual assault in Australia. There is an assumption about what people need - there's just no culture of listening or listening with any consequences.
Acknowledgement of cultural context is a valuable tool in sexual assault service delivery. The workers, managers and coordinators we spoke to had unique insights into how being in "the country" differed from the city, how populations and dominant economic industries affected how they planned to reach out to the community and why certain aspects - such as prevention campaigns - had any resonance. Being cognisant of the population's particular cultural needs - such as a town's Indigenous community - can mean the difference between connecting with that community and not being able to reach them. The complexity of the diversity of needs requires a diligent effort on behalf of service providers (COAG, 2012). These insights are specific to particular locations; however, the acknowledgment of cultural context can be a tool for any service in any regional, rural or remote location.
Staffing regional, rural and remote services can be challenging in a number of ways. Issues of funding, employing and retaining staff, boundary role issues, isolation and professional development have been well covered in the existing literature (Green, 2007; Gregory, Green, & McLaren, 2007; Mason, 2006, 2010; Neame & Heenan, 2004). Some of those issues will be touched on here, as well as strategies that local services were able to implement. In some instances, staffing innovations were a response to a lack of qualified staff in the area, a desire to extend services to boys and men, and Indigenous staff representation.
Regional, rural and remote sexual assault services often struggle to find qualified local staff (Brown & Green, 2009; Mason, 2006) or attract and retain staff from outside the community. The desirability of the services to employ local staff is based on the perceived "insider knowledge" that such staff can bring to the job, which can be important in having a unique perspective on how to engage with the community. However, "insider knowledge" could also be perceived as a negative, where service users may prefer to work with outsiders due to privacy issues and a desire to maintain anonymity, particularly in light of the stigmatised nature of, for example, mental health and sexual assault services (Roufeil et al., 2007). There is an argument to say that local workers may be better placed to address the needs of local clients (Mason, 2006). Staff from other locations may be recruited as graduates, but their experience may be insufficient for the role required.
Staffing is a juggling act that affects how many clients can be taken on and how active the service can be in education programs and community outreach. Therefore, an innovative approach to attracting staff is required. One such approach was implemented in the fruit-growing and agricultural town with a fairly large population. This sexual assault service offers service to the main town in addition to outlying towns in the region.
The manager explained:
We were advertising for counsellors in [outlying towns] and were just getting no replies. I approached the department about contracting private practitioners in my area and they said certainly, because they had heard about the problems we were having. I'm very careful [to make it] transparent how the funding is spent, as it is public money. So if [the private practitioners] say to me, "I've got a client who is really a sexual assault client", I'd say to them well, you can refer her to us, but there's no guarantee that you're going to get her [as a client after she's referred as a sexual assault client] - that would be financing their work. There were a lot of things we thought about so that it was honourable in the way it was done.
This example relates to the need to be providing services in an ethical manner (Crowden, 2010). The main aim is to provide excellent, qualified support for victim/survivors of sexual violence, including male victim/survivors of sexual assault and abuse. With a lack of staffing opportunities within the local recruitment pool, sourcing qualified providers from the private sector is an option as long as it is done within the constraints of ethics and accountability.
Prevention education and promoting positive male attitudes and behaviours are goals of the National Plan (Outcome 1) and most of the services we consulted had a component of community education and outreach as part of their service to the community. Many also delivered prevention programs to young men in schools. This indicates that there is a need for diversity in staffing in order to provide these appropriate services to different populations. For communities with similar staffing supply constraints as the example above, other options may lie outside the usual recruitment considerations.
One practitioner noted:
We know that our duty of care to those young men that we deliver prevention education to is to support them should they disclose. By using a [male] teacher rather than a counsellor, with the need to house him and all the problems associated with that, it's now more positive. So we have gone from strictly just women and children, to women and children only accessing the service, but young men can engage with a male within the prevention education space.
Another practitioner stated:
There is a need for an Indigenous male community educator. It's not really appropriate for [our female Indigenous community educator] to be delivering sexual assault information, especially when you're talking about 15- and 16-year-old boys. That's very inappropriate.
For areas with a high Indigenous population, attracting qualified Indigenous staff is a complex issue1 and more than one service commented on this difficulty while acknowledging the need for staff with cultural sensitivity.
There may also be more factors contributing to under-reporting of sexual abuse within Indigenous communities. For example, when the perpetrator of violence is known to the victim/survivor there may be reluctance within the community to disclose the offence. This reluctance can be based on past experiences of inadequate and culturally inappropriate responses from authorities and a disinclination to be the catalyst for an increase in Indigenous incarceration (Taylor & Putt, 2007). There are also sensitivities around shame (Lievore, 2003) and, although many victim/survivors in the Indigenous community attend Indigenous services2 if they are available, others prefer to attend non-Indigenous services for confidentiality purposes.
Navigating staff boundary roles
Navigating boundary roles when living and working in a small community can be a challenge for staff providing sexual assault services. The literature indicates a concern for safety, privacy and high visibility in the community (Gregory et al., 2007). Staff members work through these issues by trial and error. It can often present as an ethical dilemma as to how to react and respond if workers are approached or come across victim/survivors and/or perpetrators during non-working hours. One qualitative study found that a successful strategy was to keep all communication and interaction at a superficial level (Green, 2007). Another suggested that workers had accepted a level of responsibility for the management of boundaries and should be responsive while maintaining a professional distance (Gregory et al., 2007). Practitioners in sexual assault services are aware that community members connect them with the service, and are therefore careful not to acknowledge victim/survivors first or be overly familiar with them when in a social setting.
One manager of a service in a fruit-growing and agricultural town reflected:
It's the little things, like shopping with my husband. There are times when I have to say to him, we're not going through that checkout. He doesn't ask questions; he knows I'm saying it because of my work. It could be that a client is working on a checkout or a client is in the queue. I don't want to remind them of their sexual assault when they are getting on with normal activities. It also puts limits on my private life.
Another manager from an outback town with a large Indigenous community commented:
Everyone associates us with sexual assault. We have to be really mindful of that when we're out, if we're actually with a client or just out and about, because the assumption is that if you're seen with us, then you must have been sexually assaulted. We have to be really careful about that sort of stuff.
In regional, rural and remote service delivery, "life is not divided evenly into work or non-work activities, but rather all activity is interconnected and interrelated" (Green, 2007, p. 45). Practitioners and managers alike must be mindful of their clients, the community and the possible perceptions being made - as these can have an impact on how the community views sexual assault and victim/survivors, and can impede access to the service. The following section explores how local context creates barriers for victim/survivors to accessing sexual assault services in regional, rural and remote locations around Australia, and how services have dealt with this.
Barriers to victim/survivors accessing sexual assault services in rural, regional and remote communities
Victim/survivors' experiences of sexual and physical violence and their help-seeking behaviour can be shaped by cultural contexts (Wendt & Hornosty, 2010). The geographical distance and isolation issues faced by some regional and remote areas makes delivering services difficult, particularly specialist services (Gregory, Green, & McLaren, 2008; Neame & Heenan, 2004; The National Council, 2009; Wendt, 2009). Isolation may not just be a geographical issue; there can also be a sense of isolation that has a mental component, a sense that communities are separate from the broader social connections, which can impede people's attendance at services (Neame & Heenan, 2004).
A lack of privacy and anonymity is another key impediment to accessing services (Neame & Heenan, 2004), particularly in smaller communities where everyone seems to know everyone else (Parkinson, 2008) and there is potential for damaging gossip. In such circumstances, using sexual assault services may have implications for the victim/survivor that would make access uncomfortable for them (Gregory, Green, & McLaren, 2008; Wendt, 2009).
These issues can be exacerbated by the fact that practitioners also have multiple overlapping relationships with victim/survivors and perpetrators (Crowden, 2010; Gregory et al., 2008). It can be difficult for women to approach services for professional assistance when they have another type of relationship with staff in the service; for example, if they are neighbours or their children are friends.
Some communities may have a culture of self-reliance or coping (Hogg & Carrington, 2006; Neame & Heenan, 2004; Roufeil et al., 2007; Wendt, 2009). This may create a sense of pressure on women to avoid accessing help and contribute to the under-reporting of sexual assault. This type of culture does not hold perpetrators accountable for their behaviour, which is in itself a contextual barrier for women in these communities (Wendt, 2009).
Communities may not even acknowledge that sexual assault occurs within them, insisting that such a threat comes from "outside" the safety of their community (Wendt, 2009). This can manifest as a denial that such offences could occur in a small and close-knit community (Mason, 2001).
All of the services that ACSSA consulted for this publication were familiar with these types of barriers to accessing their services and had developed responses aimed at overcoming the issues.
Integrating the service into local community
Two services specifically mentioned trying to "demystify" the service by opening it up to community members. The idea is to have community members see and experience the service as just another part of the community. Hopefully this can facilitate access to the sexual assault services and break down some of the barriers for victim/survivors.
This was exemplified in the fruit-growing and agricultural town:
We've made an effort to have this service seen as just another part of the community, by having people, in the normal course of their working day, come to our building. We have our cars cleaned regularly by a man who runs a car wash. He picks them up and drops them off. We have tradespeople come to fix things and the gardener comes regularly. We manage this situation so that no clients are in the building at the time. Our hope is that these people will say to their family or friends "I had to fix the lights etc. at the sexual assault service today", so it become a place that can be talked about in normal conversation.
The coordinator of the service in the small city stated:
What we're trying to do is make the whole experience less confronting for young women. We invite them just to come and visit the premises - come and say hello, have a cup of tea. They don't have to talk about their story or anything.
Another way that practitioners can connect to the community is through collaboration with other healthcare and justice professionals. The following section considers both formal and informal collaborations in regional, rural and remote sexual assault service delivery.
All of the services contributing to this snapshot mentioned that collaboration with other services and with the community was essential. It seemed virtually impossible to operate effectively within a local context without ensuring other community members and service providers were on board. This connection was also seen as vital for assisting people with complex and multi-faceted problems that required attention from a variety of services such as housing, legal advice and health issues. The Time for Action report states that "service delivery must be integrated and seamless" (The National Council, 2009, p. 20). The National Plan reiterates this goal in Strategy 4.2, which identifies the need to "extend sexual assault services and domestic violence services' work with other agencies to provide flexible, innovative, inclusive and integrated services" (COAG, 2012, p. 24). Another goal of the National Plan (Strategy 1.1) is to promote community involvement - from individuals to community groups - to be active in the prevention of violence (COAG, 2012).
Depending on the local context, collaborations varied among the services we consulted. Whether collaboration was established in a formal, structured way or more informally often depended on the size and nature of relationships between various services.
Collaboration with the community can be a way to overcome barriers and resistance towards a sexual assault service. As discussed, two of the services we consulted mentioned the importance of "demystifying" the service. By facilitating participation of the people in the community, a service can harness familiarity and inclusiveness. "It is hard to challenge the proposition that local people know their own needs best" (Eversole et al., 2007, p. 15).
The coordinator of the backpacker tourist town sexual assault service explained:
As a result of a conversation with a local newspaper editor, a worker set up a competition for people to send in their stories or their ideas about what a good slogan around [sexual] consent was. That then turned into a t-shirt printing thing and it got typed into a range of other community processes that no one would have described if we'd been asked to write a project plan. It got people into the mindset of "we should actually use the language of the community", so we just need to provide opportunities to the community to do that.
This was a positive outcome that started with collaboration with the newspaper editor and expanded to collaboration with the community as a whole to engage people around ideas of sexual assault prevention, in a language they preferred. This type of engagement empowers community members to take an active role in rejecting violent behaviour and championing prevention messages.
Collaboration with other services
This same sexual assault service has also implemented a formal memorandum of understanding (MoU) between the sexual assault service, the police, and the state health service. The aim of putting in place a formal agreement was to ensure that local GPs and police were connected to the sexual assault service and would refer patients there for assistance. The need to ensure referrals from police and GPs was often a catalyst to create formal alliances; however, sexual assault services often have to overcome resistance to such alliances. Implementation of such alliances requires specific consideration of the overstretched capacity of regional, rural and remote professionals.
In the gourmet food and wine region, a practitioner explained:
In fact, in the past, at different times, when I've wanted to talk to doctor, I had to make an appointment myself and pay the gap as a client, because the only time you can get ten minutes with a doctor is if you are a patient, because they're all so busy. They just don't have time for that sort of thing.
She went on to explain:
Police are a completely different team. I have had some police officers that are very supportive; others are not.
This practitioner is describing her difficulty in developing formal arrangements for referral and support because of the personalities involved rather than the relationship between one organisation and another.
Another practitioner from a regional centre commented on the importance of instigating relationships with the community:
Each year we approach the school - it's been happening now for probably ten years or more. We make contact with the school chaplain, the school psychologist, the school nurse, the Year 10 coordinator. That in itself is a good exercise, even if the school decides not to take up the offer of us going in to give the [prevention] talk. It means that we've had contact and that they're aware of us. So it's all part of that process of breaking down some of the barriers about young people accessing the service.
Often having multiple "points of entry" to the one service is desirable. For instance, in many metropolitan areas, services are set up to engage via multiple referral pathways, where victim/survivors are referred by police, GPs and mental health practitioners to sexual assault counselling services (Lievore, 2003) and then through to the criminal justice system (Parkinson, 2010). Many funding agents and central bodies have recognised the need for such formal arrangements in regional, rural and remote sexual assault services and have facilitated these arrangements.
Consideration of a range of service delivery models may enable the formulation of a model that can be applied most appropriately across sexual assault services while still taking account of local factors that impact on needs. Roufeil and Battye (2008) outlined a number of service delivery arrangements for family and relationships service delivery that could potentially be transposed to the sexual assault sector.
An example of using partnerships in order to maximise services was operating in the fruit-growing and agricultural town where the sexual assault service had created an arrangement with the local domestic violence crisis care hotline. Instead of spending a lot of money setting up a separate service, money was used to train the local domestic violence crisis workers in sexual assault crisis care delivery.
The practitioner explained:
It's a benefit to the workers because they get paid extra on-call money; it's good for us because we've trained counsellors and we know that they can actually do the job. So the Memorandum of Understanding has worked.
In the regional city a formal collaborative process had been set up in the form of a sexual assault advisory group. This group included police, government health, the sexual assault service and victim support and child protection service. The practitioner said:
We sit once a month and sometimes that'll be about big picture issues that need to be addressed, but also it might be actually going back and doing some case reviews of the crisis cases that have presented, particularly if there has been a breakdown of communication.
Another such initiative comes from the outback town with a large Indigenous population. It has a formalised sexual assault and domestic violence program that runs out of the local Aboriginal Health Clinic. For specific events, such as White Ribbon Day, there is a group of service providers that comes together more informally to coordinate an event for the community.
The practitioner at this location explained:
Last year was amazing. We had tradesmen - it [White Ribbon Day] was actually held in a beer garden at the local pub at 6 o'clock. We had the local ambulance service and their young kids. There were fire fighters, there were policemen who came in their uniforms. They all took the pledge - it was fantastic. There were heaps and heaps of agencies involved.
Often formal collaboration can lead to informal networks and connections through events such as those described above.
The insights presented in this Wrap highlight the fact that some of the issues raised by the services were common across a variety of communities but solutions for dealing with the issues were generally local and context-specific, arising from innovations and flexibility applied by the services.
Many of the challenges discussed here have been faced by non-metropolitan services for a very long time and issues of geographical isolation and increased costs, for instance, are not likely to disappear any time soon. Some of the challenges were specific to a community, reflecting the locality's particular needs, values and the availability of local supports such as close collaborative ties within that service delivery environment. The ability of these services to develop their own responses to issues suggests that the services are an untapped resource of ideas that should perhaps be cultivated in order to help develop an effective and flexible model of sexual assault service delivery for non-urban communities. Unlike family relationship services, which are the focus of the review by Roufeil and Battye (2008) discussed earlier, and which are largely a federal policy concern, sexual assault services may be, in a sense, more divided by state differences in policy and funding. However, the similarities in the issues being faced and the ability of the services to respond in their own way indicate that collaborative input and evaluation of the various strategies used by services could be a beneficial mode of tackling the ongoing issues of sexual assault delivery in remote, rural and regional Australia.
Many of the strategies outlined in the National Plan, such as attending to diversity, removing barriers to access for victim/survivors, collaborating with health services and fostering community involvement are all evidenced in the efforts of the providers we consulted. What was apparent, however, was that stakeholders identified a lack of opportunity to evaluate effectively any of the measures that had been taken in order to overcome the various problematic aspects of their work. As many of the responses were individual and informal service responses, this is not surprising. Perhaps a way forward would be the provision of resources and expertise to enable consideration of the merit of some of the solutions developed, such as measuring how many more victim/survivors could be served by formalising a partnership with private providers, or how many more Indigenous clients were attending a service once an informal "drop-in" service was provided. Time-strapped services may find it difficult to incorporate such evaluations, but the wealth of local knowledge and experience evident in ACSSA's consultation with these services indicates that there are rich data and information that could be used to define a flexible model of service delivery that indicates what works in remote, regional and rural sexual assault services.
The generosity of the regional, rural and remote sexual assault services that ACSSA consulted has enabled this snapshot of the issues they confront in their delivery of services to sexual assault victim/survivors. What became most apparent from these discussions is that these services are innovative and flexible, but research and evaluation is needed to translate these ideas and practices into effective models of service delivery that can be best shaped to reflect the needs of regional, rural and remote locations in providing coherent and consistent specialist sexual assault services.
Explanatory note on consultations
This consultation was conducted as part of ACSSA's networking role. It is not intended to be representative, but to communicate issues raised with ACSSA during networking activities.
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Liz Wall was a Research Officer and Mary Stathopoulos was a Senior Research Officer with the Australian Centre for the Study of Sexual Assault at the Australian Institute of Family Studies.
The authors would like to thank our external reviewers for their time, expertise and feedback. We would also like to thank AIFS staff, particularly Jacqui Stewart, Daryl Higgins and Antonia Quadara for their guidance and feedback throughout the production of this publication. Finally, thank you to all the service providers and managers who took time out to speak to us about their local communities, and whose expertise informed this Wrap.
Wall, L., & Stathopoulos, M. (2012). A snapshot of how local context affects sexual assault service provision in regional, rural and remote Australia (ACSSA Wrap No. 13). Melbourne: Australian Centre for the Study of Sexual Assault, Australian Institute of Family Studies.