Evaluation of the Bringing them home and Indigenous mental health programs

6.4 Limited geographical coverage of the programs

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The fourth major limitation is the limited geographical coverage of the Programs. This is a problem for the Link-Up, BTH and SEWB RC Programs. (This is less of an issue for the Mental Health Programs because most aim only to be relatively local initiatives.)

The Link-Up services are intended to provide national coverage. In jurisdictions where there is only one Link-Up service, it is meant to provide services to its whole State/Territory.

The coverage of BTH services and SEWB RCs varies according to each service provider, as each provider determines its own boundaries (eg the SA SEWB RC covers the whole State, whereas the Rockhampton SEWB RC in Queensland covers an area of only 100kms, no more than two hours’ travel.) It is not possible to estimate the overall proportion of coverage nationally for either the BTH or SEWB RC Programs.

Link-Up and BTH services may be covering areas up to a couple of hours drive away, or even more. The areas covered appeared to be particularly large in WA – for instance they could be up to five hours drive away. This is perhaps not surprising given that WA is the largest State.

It appears likely that the geographical coverage of the programs is far less in practice than in theory considering the official boundaries covered by the services. This is because in many instances services covering large geographical areas tend to focus primarily on clients in their immediate vicinity, since such clients provide more demand than the services can meet. Coverage of areas beyond services’ immediate vicinity therefore tends to be much more limited, sporadic or patchy. Covering large areas, particularly on an outreach basis, is particularly challenging for services with only one or two workers (since it can mean large periods of time away from the office), and no or limited access to a vehicle.

As discussed in chapter 7, the lack of coverage is also partly the result of the lack of general SEWB services in Aboriginal communities.

Further barriers to services conducting more outreach work include Occupational Health and Safety issues (it may not be safe for staff to be conducting outreach work alone), or lack of personal safety insurance. For example, while conducting outreach work to prisons is desirable given the high proportion of Stolen Generations members amongst incarcerated Aboriginal inmates (see chapter 6), for counsellors visiting clients in prison, workers’ compensation may not apply. (In December 2006 the Link-Up services were invited to investigate the legal liability position and to provide OATSIH with quotes for this cover. OATSIH will consider providing assistance to pay reasonable costs in relation to this insurance.)

In addition, it was reported that distance from a service can be a significant disincentive for potential clients to contact a service. This is particularly true for first generation Stolen Generations members since they may often have no private transport, be on low incomes, be elderly, and/or in poor health.
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This issue is also linked to two others. Firstly, the services currently have very heavy caseloads (as discussed in Chapter 8), which would, in practice, make it very difficult to cover a bigger geographical area. Secondly, services are generally taking a reactive rather than proactive approach to shaping service delivery and the client base.

There is a similar problem with SEWB RCs in that SEWB workers in the city in which the Centre is located tend to receive the most professional support and be most satisfied with the service provided.

Those further away tend to get less support. For instance:

• They are less likely to have access to professional supervision through the Centre (although some Centres do provide this by phone).
• Where they are advised of training opportunities, they are often in the city in which the SEWB RC is located, and it can be harder to attend these given the significant time and cost that may be involved in attending. In some instances only receiving short notice of training opportunities compounds this problem.

However, some Centres have been more successful in meeting the needs of SEWB workers in areas beyond their own city. Nunkuwarrin Yunti in SA and the Victorian SEWB RCs illustrates that it is possible for a SEWB RC to provide effective professional support to SEWB workers in a large geographical area – in these instances, the whole of SA and Victoria.

The SA Centre proactively implements a number of strategies to meet the needs of SEWB workers based in areas other than Adelaide, including providing training around the State on a regular outreach basis. This means that workers are not always required to travel to Adelaide to participate in training opportunities. Nonetheless, these activities have reportedly only been possible because the Centre has been very successful in attracting additional funding from various sources, including the Aboriginal Affairs and Reconciliation Division (Department of the Premier and Cabinet), philanthropic organisations and OATSIH (under the now defunct Innovative Grants Scheme (discussed further in chapter 7).

The Victorian SEWB RC provides more training in regional areas than in Melbourne as the majority of BTH Counsellors are located outside of the metropolitan area. This Centre also provides support and follow-up to individual BTH Counsellors on request, either by phone or special visits to the ACCHS in the regional area. (However, it was reported that Link-Up workers have received much more limited support.)

GPP1:

Link-Up and SEWB RC services should provide regular outreach services to clients to ensure that they provide an adequate service to their whole catchment area. First generation members should be given priority access to outreach services by Link-Up and BTH services. SEWB RCs should provide outreach support to mental health workers in these services

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