Evaluation of the Bringing them home and Indigenous mental health programs

5.1 Link-Up and BTH services have provided services to a large number of Aboriginal clients

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Quantitative data on the number of client contacts (and in the case of the BTH Program, the gender and Aboriginal status of client contacts) for both Link-Up and the BTH Program are provided below. As discussed in chapter 3, this information was provided to the consultants by OATSIH, based on data provided by the services to OATSIH annually as required by their funding agreements.

In summary, while there are some questions about the complete accuracy of the data, this information shows that the Link-Up and BTH services have undoubtedly provided services to a large number of Aboriginal clients. This should be regarded as a major positive achievement of these two programs.

Nonetheless these data also support the finding from the qualitative consultations that the level of demand exceeds the capacity of the Link-Up and BTH services to respond adequately and promptly to clients, and that huge caseloads contribute to staff burnout (this issue is discussed further in chapter 8).

5.1.1 The Link-Up services
5.1.2 BTH services

5.1.1 The Link-Up services

Some basic data on Link-Up client outcomes are available through Foxtrot (the data management system used by all Link-Up services). However, the consultations indicated that the available data generated through Foxtrot are unreliable. On the one hand, the data is likely to be incomplete and therefore an under-estimate for various reasons such as:

• Services are not all completing all of the fields required (reportedly because it is very time-consuming to do so).
• Operator error.
• The Foxtrot software has, to date, not had the capacity to move data between family members automatically, causing operators to have to enter and exit individual files many times, recording the same data. This has led to operators being forced to compromise the degree to which they spread the data, according to other workload demands, or to fatigue or oversight. This facility is being built into a new web-based version of Foxtrot, due to be installed around May 2007. It is estimated that this will reduce administrative time by at least 50%, enhance the quality of data stored/collated, and hence improve accurate reporting capabilities.
• There are inconsistencies between the services in how they use the database, depending in particular on differences in skill levels.

(It should be noted however that a comprehensive Foxtrot training program is to be conducted in early 2007, which should help address some of these issues for the future.)

Conversely, it is also possible that the data (on the number of reunions and clients) may be an over-estimate in some instances also – for instance because it is not based on actual figures collected, or due to concerns over possible loss of funding or withdrawal of staff.

In short the Foxtrot data is likely to be unreliable. However, no other data on the performance of Link-Up services was available for the evaluation. The need for OATSIH to monitor the accuracy and consistency of Foxtrot data is discussed in chapter 11.Top of page

Number of client contacts

According to the data, there were a total of 35,178 client contacts by Link-Up since 1998 (see table 5.1). The NSW Link-Up service had by far the greatest number of client contacts (13,590), followed by NT (5,963) and Queensland (4,250).

The number of client contacts has varied markedly between years, ranging from 2,566 to 8214, and with an average of 5,025 per year (see table 5.1). In 2005-2006 there were 5,659 client contacts with a Link-Up service.

It is important to note that the number of client contacts does not necessarily refer to discrete new clients each year. The fieldwork indicated that Link-Up clients may often stay ‘on the books’ for a considerable period of time, due to factors such as the length of time taken to locate records and organise reunions, shortage of staff resources and the fact that the Link-Up services often do not officially ‘close’ cases unless requested or the client passes away. There is therefore likely to be a considerable overlap between years in the identities of the client contacts. It would therefore be misleading to use the cumulative number of persons assisted as an accurate representation of the total client load over time. Thus the total number of clients seen by Link-Up between 1998-1999 and 2005-2006 is likely to be considerably less than 35,178, but more than 1,376 (the total number of reunions).

Nonetheless, even taking the above factors into account, the data indicates that the Link-Up services have dealt with a very large number of clients each year, particularly considering the small number of services (currently 11) and the fact that the services typically have only one or two Link-Up workers per service.Top of page

Table 5.1: Number of client contacts from 1998-1999 through to 2005-2006

Year	Vic	Qld	Tas	NT (northern)	NT (southern)	SA	NSW	WA	Total
1998-1999	No state/territory based figures available								0
1999-2000	280	429	153	1,260	77	67	300	na	2,566
2000-2001	87	na	153	900	35	95	1,862	475	3,607
2001-2002	853	1,186	na	54	343	2,129	2,783	na	7,348
2002-2003	34	803	152	1003	1134	1,461	2,610	1,017	8,214
2003-2004	374	681	na	96	104	1,653	1,847	171	4,926
2004-2005	60	851	na	347	154	792	417	237	2,858
2005-2006	64	300	na	154	302	330	3771	738	5,659
Total	1,752	4,250	458	3,814	2,149	6,527	13,590	2,638	35,178

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Number of reunions

An important core activity of the Link-Up services is to organise reunions. The Foxtrot data available show that between 1998-1999 and 2005-2006, the number of client reunions reported annually has fluctuated considerably, ranging from 100 to 289 and with an average of 182 per year (see table 5.2). In the 2005-2006 financial year, 177 reunions took place nationally.

There are reportedly inconsistent approaches used by Link-Up in relation to which family members are funded to be involved in reunions. Some Link-Ups only allow immediate family members, whilst others include extended family (eg cousins, aunts, uncles) and family friends. It was argued that the latter approach can inflate the numbers reported as being reunited.

The data on the number of reunions also do not include community reunions where many people are reunited on one occasion.

Since clients are only allowed to have one reunion according to Link-Up guidelines, the cumulative total number of client reunions should refer to discrete clients (unlike the data on the number of client contacts, as explained above). Over the eight-year period, a total of 1,376 client reunions occurred. The NSW, WA and Queensland Link-Up services had the highest numbers of reunions, while Victoria and Tasmania had the lowest.Top of page

Table 5.2: Number of client reunions from 1998-1999 through to 2005-2006

Year	Vic	Qld	Tas	NT (northern)	NT (southern)	SA	NSW	WA	Total
1998-1999	No state/territory based figures available								119
1999-2000	5	6	16	18	2	3	50	0	100
2000-2001	4	24	8	17	3	5	54	9	124
2001-2002	6	103	6	17	19	9	48	59	267
2002-2003	12	90	1	31	10	27	23	95	289
2003-2004	3	24	na	40	19	20	16	41	163
2004-2005	15	13	na	26	21	21	85	37	218
2005-2006	10	8	na	24	10	16	81	28	177
Total 1	55	268	31	173	84	101	357	269	1,457

¹The ‘total’ figures by State do not tally with the ‘total’ figure for all the jurisdictions cumulatively, due to the absence of data by State for 1998/1999.

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5.1.2 BTH services

Since the 2001-2002 financial year all ACCHSs receiving BTH funding have been asked to report the total number of client contacts made by BTH Counsellors in that year through the annual BTH Questionnaire.

Number of client contacts

In 2004-2005 (the latest year for which information is available) 39,300 client contacts were reported. Between July 2001 and June 2005, a total of 142,000 client contacts were reported (see table 5.3). It should be noted that the data on client contacts excludes group work.

Overall the total number of BTH client contacts has increased since 2001-2002. Although there was a significant drop in client contacts between 2002-2003 and 2003-2004, it is likely that this reflects under-reporting of the data as discussed below.

The 2003-2004 and 2004-2005 figures are likely to be an under-estimation of the total number of client contacts for various reasons including:

• a number of services were not able to report on how many clients had been seen during the survey periods
• eight services did not provide client contact figures because they had no BTH Counsellor, or were experiencing administrative problems
• a number of services may have quoted client numbers instead of client contacts (defined above)
• some services estimate their client numbers rather than base them on actual figures collected
• counselling is often conducted in group settings, and figures are often not recorded for groups.

No information is available on the number of clients receiving BTH services over a given period.

Table 5.3: Total client contacts for BTH counsellors

Table 5.3 is presented as text in this html version for accessibility reasons.

• 2001-2002 - total 28,508
• 2002-2003 - total 37,258
• 2003-2004 - total 36,733
• 2004-2005 - total 39,287Top of page

Aboriginal status and gender of clients

Services are also asked to provide a breakdown of client contacts by Aboriginal status and gender.

In terms of Aboriginal status, the proportion of non-Indigenous client contacts has varied between 5-10%, and had fallen slightly between 2003-2004 and 2004-2005 from 9% to 5% (see table 5.4). Since the BTH program is supposed to be solely for Aboriginal clients, there could be some concern that any of the clients seen under the program are non-Aboriginal. However, the qualitative consultations indicated that non-Aboriginal clients are generally those with close Aboriginal family members (eg a spouse) or people whose Aboriginal status was yet to be formally confirmed (as discussed in chapter 9, establishing Aboriginal identity can be particularly difficult for Stolen Generations members).

The BTH Program has a far greater number of female than male client contacts: there are around two female client contacts for every one male client contact (see table 5.4). This is consistent with the finding from the consultations that men are more reluctant to approach BTH services or to be engaged with mainstream counselling approaches (see further discussion in chapter 9). The proportion of male and female client contacts has remained fairly constant over the four reporting periods.Top of page

Table 5.4: Gender and Indigenous status of client contacts

Year	2001-2002	2002-2003	2003-2004	2004-2005
Aboriginal male	36%	34%	29%	37%
Aboriginal female	54%	60%	62%	59%
Aboriginal total	90%	94%	91%	95%
Non-Aboriginal male	4%	2%	3%	2%
Non-Aboriginal female	6%	4%	6%	3%
Non-Aboriginal total	10%	6%	9%	5%
Total males (Aboriginal and non-Aboriginal)	40%	36%	32%	39%
Total females (Aboriginal and non-Aboriginal)	60%	64%	68%	61%

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