Evaluation of the NT MOS projects
MOS Plus within an integrated service framework
Up to Closing the Gap: Northern Territory
Executive summary- Acronyms
- 1. Introduction
- 2. Methodology
3. Findings- 4. Analysis & recommendations
- 5. Appendices
MOS Plus comprises a suite of services encompassing: direct therapeutic case work, family and community liaison, community education and professional development. A remote Forensic Medical Examination (FME) service is also an element of the suite of services introduced. This is subject to an internal review, separate to this evaluation.
Literature talks about taking a holistic approach to addressing the health and wellbeing needs of Aboriginal people, and needing to take a broad view of the social determinants of health. Some literature notes that children presenting with inappropriate sexualised behaviours are likely to have experienced childhood trauma and a range of other factors, and recommends integrated services as well as specialised therapeutic services.21 Therapeutic counselling for victims by appropriately qualified services is seen by some research literature as part of the solution to a preventative approach to intergenerational abuse, as well as having ongoing health and wellbeing repercussions.22
Literature further notes programs and services provided to Aboriginal children and their families need to be flexible in design so that they meet the needs of the local community, and in the way services are provided.23
This was evident in the snapshot of ten communities visited during the evaluation. It was clear in some communities the most effective and utilised program was the preventative education and awareness raising program in schools; whilst local service providers in other communities accessed the therapeutic counselling service, only, for children and families and often were not aware of the other MOS Plus services available. Some communities have a range of regular visiting services (including counselling services such as school counsellors, family counsellors from non-government agencies, drug and alcohol counsellors), others did not.
Current support for the service is most evident in the referral source, and increasing number of case work service events (see Figure 12).
The most common referral sources are Child Protection services and the NT Sexual Assault Referral Service (SARC) (21.4% and 18.6% respectively) (see Figure 8). This may reflect the initial MOS sexual abuse service focus, and the referral protocols in place with NT DCF. Other referral sources of note include health services (clinics or hospitals) 15.9% and educational facilities (15.0%), and family members (10.5%).
However, the evaluation found varying levels of knowledge and understanding of the referral process amongst both outreach and local service providers. Community members with whom we spoke in the snapshot of ten remote communities were not familiar with the service, and therefore were not aware of how to access it.
Some stakeholders expressed concern that a notification to Child Protection was required prior to referring to the MOS Plus service. Involving the statutory authorities was considered to be the action of last resort, and that there should be opportunities to bring in supports to assist prior to 'bringing in the heavy hand'. Others raised concern that the screening of the intake process through Child Protection, relies on third parties to pick up the recommendation for MOS Plus service involvement with the family.
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The need to align intake and referral processes and consider pathways that enhance access to services and supports, also accord with recommendations in the Growing them strong, together Report24 which include:
- That government and non-government organisations work jointly to develop cross-sector operational guidelines around collaborative practice and information sharing
- Development of a 'dual pathway' process for the referral and assessment of vulnerable children and families
- Enhancement of the child safety and wellbeing roles of other government agencies and personnel.
Some stakeholders interviewed spoke of their support for the protocol of a 'warm referral' - whereby the family is advised of the MOS Plus services, and agrees to the initial involvement. This was considered to indicate a willingness to accept support and counselling, a 'readiness' identified by the family themselves. Others spoke of the challenge in expecting 'self referrals' from families directly to the MOS Plus service, as is necessary with a voluntary service where people can choose whether to engage in counselling. The view was that in low socio economic areas, people are not always aware of the services available, and knowledge is the first step in actively seeking out a service.
The following provides the demographic profile of MOS Projects' case work clients.
Just under two-thirds of MOS Projects' clients were female (60.5%), accounting for 133 out of 220 clients, compared with 87 males (see Figure 9). The gender variation was most pronounced in Katherine, where 67.9% of MOS Projects' clients were female, and most balanced in Central, where 45.7% of clients were female.
Children aged 6 to 11 years (48.6%) and 12 to 15 years (33.2%) accounted for the substantial majority of MOS Projects' clients. There were few clients aged 1 to 5 years (12.3%) and very few over 16 years (5.9%). This pattern was broadly consistent across the Regions, with the exception of Central Australia where approximately two-thirds of clients (60.9%) were aged 6 to 11 years (See Figure 10).
Figure 8: Referral sources, as a percent of total cases
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Text version of Figure 9
Referral sources, as a percent of total cases:- Child Protection Services - 21.4% (N = 47)
- SARC - 18.6% (N = 41)
- Health clinic - 15.9% (N = 35)
- Education facility - 15.0% (N = 33)
- Family member - 10.5% (N = 23)
- Police - 6.4% (N = 14)
- MOS initiated - 2.7% (N = 6)
- Community - 1.8% (N = 4)
- Self - 1.4% (N = 3)
- Other - 6.4% (N = 14)
Figure 9: Gender of MOS Projects' clients by region
Text version of Figure 9
| Male % (N = 87) | Female % (N = 133) | |
|---|---|---|
| Central Australia (N = 46) | 54.3 | 45.7 |
| Barkly (N = 9) | 44.4 | 55.6 |
| Top End (N = 112) | 36.6 | 63.4 |
| Katherine (N = 53) | 32.1 | 67.9 |
| Overall (N = 220) | 39.5 | 60.5 |
Figure 10: Age of MOS Projects' clients by region
Text version of Figure 10
| Age 1 to 5 years % (N = 27) | Age 6 to 11 years % (N = 107) | Age 12 to 15 years % (N = 73) | Age > 16 years % (N = 13) | |
|---|---|---|---|---|
| Barkly (N = 9) | 22.2 | 33.3 | 44.4 | 0.1 |
| Central Australia (N = 46) | 17.4 | 60.9 | 17.4 | 4.3 |
| Katherine (N = 53) | 13.2 | 47.2 | 32.1 | 7.5 |
| Top End (N = 112) | 8.9 | 45.5 | 39.3 | 6.3 |
| Overall (N = 220) | 12.3 | 48.6 | 33.2 | 5.9 |
Footnotes
21 Fan, 2007; Flaxman et al, 2009 Appendix D: Literature Review
22 O'Brien, 201; Purdie et al, 2010. Appendix D: Literature Review
23 Appendix D: Literature Review
24 Growing the strong, together: Promoting the Safety and Wellbeing of the Northern Territory's Children. Report of the Board of Inquiry into the Child Protection System in the Northern Territory 2010. p82 Summary Report