Northern Territory Community Services high risk audit : executive summary & recommendations
Howard Bath ; prepared for the Northern Territory Department of Health and Community Services.; Community Services high risk audit
Bath, Howard; Boswell, Diana; Northern Territory. Dept. of Health and Community Services; Thomas Wright Institute
E-Publications; E-Books; PublicationNT
Made available via the Publications (Legal Deposit) Act 2004 (NT).
Date:2007-11; Associate auditor: Diana Boswell. At foot of title: The Thomas Wright Institute.
Public welfare administration -- Risk management -- Northern Territory; Human services -- Risk management -- Northern Territory; Risk management -- Northern Territory; Risk assessment -- Northern Territory
Dept. of Health and Community Services
13 p. ; 30 cm.
Check within Publication or with content Publisher.
NT Community Services High Risk Audit November 2007 6 Major themes from case studies Cumulative risk Every case reviewed was complex with multiple issues involving the individual, the family, the community, human service programs and legislative frameworks. The epidemiological concept of cumulative risk applies in both the assessment and the management of risk. The human element and case coordination Despite attempts by the Programs to formalise and regulate decision-making around risk management, actual decisions often reflect personal values and beliefs and the existing Program climate. These factors can lead to a defensive stance that involves a simplifying the situation by concentrating on only one element of risk; redefining it as of low level of concern; or passing on the responsibility to others. In a parallel process, Programs can concentrate only on their perspective, refusing to see the bigger picture; they can displace their frustration onto other Programs (blaming them for inadequacies in services); they can split by aligning themselves with the client against other services; or they can simply give up (there is nothing we can do so we dont try). While such dynamics are understandable they actively work against the development of effective problem-solving strategies. Some of these issues can be addressed by improved training, support and supervision of staff, but in the long term, substantial progress is unlikely to occur without a powerful process of case coordination and collaboration with other services that shares the burden and relieves individual and Program stress. Options for addressing this need are canvassed in the section on cross-Program issues. Gaps in treatment and accommodation services A recurring issue in the case studies was a lack of services to which case workers could refer their complex clients. In Mental Health, rehabilitative programs appeared limited in Darwin and non-existent out of Darwin. Families bore the brunt of risk of immediate harm and of supervising medication and dangerous behaviours. In the AOD Program, the cases referred emphasised the lack of residential services for aboriginal people outside Darwin and of intensive services for young adolescents anywhere. Also of immediate concern are the very limited options for substance abuse treatment for young people, particularly outside Darwin. For both adolescent and forensic mental health clients, there are no appropriate accommodation options in the NT. Lack of targeted case work services The lack of targeted case work services was also a common theme, particularly for youth. Many of the AOD and FACS case notes identified extreme risk to self, from others and sometimes to others when the individual was entering adolescence. Only Alice Springs has a targeted youth program (Youth at Risk program of FACS) there appears to be a pressing need for such services elsewhere in the NT.
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