Evaluation of the Bringing them home and Indigenous mental health programs
8.2 Professional support for staff
Given the variable skills and qualifications of staff in the Link-Up and BTH programs, and the specialised nature of the programs and target group, access to ongoing training and professional support (eg debriefing, professional supervision) for staff is especially critical. The consultations indicated that access to both forms of this support is extremely variable, and overall inadequate. Training and other forms of professional support are discussed in the following sections:
8.2.1 TrainingThe standard BTH contract requires that BTH staff undertake continuing education and/or in-service training, including BTH related training, that encourages further skill development in addressing the needs of Aboriginal peoples (including the SEWB needs of those affected by past removal policies).
According to data from the BTH Questionnaire, most BTH Counsellors have undertaken some form of training for each of the years 2002-2003 through to 2004-2005, and in 2004-2005 half had undertaken training in Stolen Generations issues (see table 8.1).
However according to the consultations, while staff of the Link-Up and BTH programs have access to some training, overall it is not enough to meet their professional development needs. Some staff have good access to training, others have taken part in no or minimal amounts of training, and other staff are located somewhere along this spectrum. High staff turnover also exacerbates issues concerning access to training.
Those staff who had better access to training tended to:
- Be located in metropolitan areas – those in more regional and remote areas tended to have less access due to the scarcity of local training opportunities (particularly on more specialised topics of relevance to the programs), in some instances have lower levels of awareness of training opportunities, and incur the expense and time involved in attending training in metropolitan locations.
- Have SEWB RCs who more effectively met their training needs (this is discussed further below in this chapter).
As noted in the literature review (chapter 4), there is a lack of documented material concerning mental health approaches specifically for Stolen Generations members, and the key program identified in the review was the Muramali Program. Many BTH and Link-Up staff consulted had undertaken this program, and all spoke extremely highly about how useful this training was.
- All BTH Counsellors should be given access to and participate in appropriate training on a regular basis.
Table 8.1: Staff training undertaken by BTH counsellors
|Training in Stolen Generations issues||Undertaking accredited training||Other formal training||None|
The role of SEWB RCsClearly one of the primary responsibilities of SEWB RCs is to provide education and training for the BTH and Link-Up workforce, particularly in areas where staff currently lack skills and qualifications. Unfortunately, not all SEWB RCs are meeting this responsibility, meaning the workforce continues to miss out. While some SEWB RCs have been very active in supporting their local workers (eg in SA, Victoria and Rockhampton), in other States' SEWB RCs have not even undertaken an assessment of what training is needed. One Centre reportedly declines approaches from BTH and Link-Up workers for relevant training on a regular basis (and the Centre denied that it even receives any OATSIH funding for most of the consultation session).
As noted in chapter 6, there appears to be some confusion about the role of the SEWB RCs, which has translated into limited training and other support for Link-Up workers and BTH Counsellors.
Where SEWB RCs are active and engaged with the SEWB workforce, workers have a greater understanding of their roles and enjoy better relationships with others in the sector. Where SEWB RCs are not providing adequate support, workers can feel professionally isolated and unsure of how their work relates to that of other services.
The role of the SEWB RCs and their performance is discussed in more detail in chapter 9.Top of page
8.2.2 Debriefing, professional supervision and other supportGiven the stressful and complex nature of the work conducted by Link-Up and BTH workers, access to debriefing, professional supervision and other support is a major area of need. This is recognised in the standard BTH contract with services, which specifies that BTH workers must receive professional supervision and debriefing from a qualified mental health professional, and that the costs of this must be met by the lump sum funding provided for each BTH worker.
As with access to training, the consultations indicated that BTH and Link-Up workers' access to debriefing, professional supervision and other support is extremely variable, with some having access to good support processes and others not. Overall the support provided is inadequate to meet workers' needs. This is a particular problem in rural and regional areas, where BTH and Link-Up workers are more likely to feel professionally and geographically isolated. Those BTH Counsellors with better professional supervision and support processes had access to professional supervision from either a qualified mental health professional within their team, a professional based at their RC, and/or an external agency. Only a small number of BTH Counsellors reported accessing support through the latter two channels.
Some further data on the kinds of support offered to BTH Counsellors is available in the annual BTH Questionnaire. The proportions of BTH Counsellors receiving the specific forms of support available have varied somewhat over time but the most common forms in 2004-2005 were telephone support (82%) and debriefing (82%), followed by case consulting (82%) and peer support (76%) (see table 8.2).
Some services responding to the BTH Questionnaire indicated that BTH Counsellors take part in a mentoring relationship of some kind. Where a mentoring relationship exists, services are asked to indicate the types of people that provide this type of support.
In 2003-2004 and 2004-2005 the most common type of mentoring relationship was with a senior counsellor based at another service (see table 8.3). In general, psychiatrists have been used least often for mentoring relationships.
'Other' types of mentoring arrangements listed by funded services in 2003-2004 and 2004-2005 included: community forums on specific issues, support from senior Elders and Aboriginal peers, BTH Counsellor program management staff, and medical and allied health professionals (eg social workers, mental health team professionals).
As required by the BTH contract, counsellors in mainstream counselling programs would generally have access to professional supervision from a qualified mental health professional. While it is recognised good practice for this to be on a one-to-one basis by a qualified mental health professional from outside the organisation, in practice it is often a qualified mental health professional within their team (eg their manager), or an external qualified professional brought in to conduct group supervision sessions on a regular basis (which is more cost-effective).
Applying this here, it is important that at a minimum all BTH staff have access to regular supervision by a qualified mental health professional. This should be either within their team if there is a team member qualified to conduct this role, or ideally through an external organisation if this is unavailable internally (on either a one-to-one or team basis). The latter is particularly likely to be required in regional/remote areas, which tend to have smaller BTH teams and less BTH Counsellors with mental health qualifications.
The consultations suggest that currently some but not most BTH Counsellors would satisfy these criteria for supervision.
The Adelaide, Melbourne and Gippsland BTH services provide their BTH Counsellors with very regular external supervision with a qualified mental health professional (eg once a week for the Gippsland service), even though they all have qualified mental health professionals available within their teams.
- All BTH Counsellors should have access to regular supervision by a qualified mental health professional, either within their team or through an external organisation (on either a one-to-one or team basis).
Table 8.2: Support offered to the BTH counsellors
|Counsellor networking meetings|
|Regular meeting with clinical supervisor or mentor|
Table 8.3: Types of mentoring relationships used by BTH counsellors
|Senior counsellor from own service|
|Senior counsellor based at another service|