Evaluation of the NT MOS projects
Service and staffing models
Up to Closing the Gap: Northern Territory
The staffing profile and service organisational model is inextricably linked to the service characteristics.
Cultural competence and sensitivities of staff were considered essential, both in terms of the service achieving its aims and ensuring appropriate engagement to foster community ownership of, and support for, the service.
The majority of key stakeholders interviewed from government, outreach and local organisations and service providers spoke of the challenges of recruitment and retention of appropriately qualified staff in the NT. This is heightened further in a service such as MOS Plus which requires specialist skills and qualifications, alongside experience in working with Aboriginal children and families, in remote communities.
The outreach service model and the remote service setting require skill and experience in engagement with communities, families and local organisations to ensure both an understanding of the service, and establishment of relationships in community. Gaining trust is required before the therapeutic service relationship can develop.
The core foundations of the MOS Plus service organisation and staffing profile are supported by those interviewed " a central management team providing leadership and professional guidance to outreach teams. The current management team comprises: Project Manager; Principal Clinical Practice Advisor; Information Manager; Regional Team Managers - Top End/Katherine, and Central Australia/Barkly and administration support. All are based in Darwin with the exception of the Central Australia/Barkly RTM based in Alice Springs with some administration support.
Given the diversity, number and geographic spread of communities across the NT and the complexity of service development and provision, an overall project manager is required. A number of stakeholders interviewed commented upon the dedication required by MOS Plus outreach staff to deliver services under challenging conditions. This was discussed in relation to: the nature of the service itself; the travel; poor accommodation options; time away from friends and family; and the reliance on others.
The current model also includes the role of Principal Clinical Practice Advisor. Given the highly specialist nature of therapeutic counselling for children and young people in relation to trauma, abuse and neglect and engaging in this professional relationship in remote Aboriginal communities, this role is considered essential.
The current model also provides for two Problem Sexual Behaviour (PSB) Advisor roles, however recruitment to these positions has not been successful to-date. The MOS Plus management team is exploring strategies to support PSB capacity within the service. Service organisations in other jurisdictions provide programs in this specialised field in a range of ways. For example the Adolescent Services Enfield Campus (ASEC) in South Australia, provides specialised counselling to young people 12-18 years with a range of challenges including: anxiety and withdrawal; difficulties with emotional regulation; complex family issues; experience of trauma; and sexualised behaviours.20
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Of equal importance to ensuring the provision of specialist counselling and support, is cultural competence. A Practice Advisor role in this critical area could provide leadership, expertise and mentoring for the ATROs in particular, and for non-Aboriginal staff. As discussed in this Report a more clearly defined and expanded role for ATROs is suggested, which could be supported and further developed by a senior Aboriginal advisory role.
Field work supervision, mentoring, professional development and a strategic approach to community engagement is required. There is also a requirement to support caseload control in this sensitive and challenging area.
The role of Regional Team Managers (RTMs) are essential to this function. Currently there are two - Top End & Katherine; and Central Australia & Barkly. For a range of factors including, but not limited to: the geographic spread of communities; diversity of communities; need for 'local' cultural competence; need for fieldwork supervision and mentoring; and tailored professional development, the evaluation has found there is a clear requirement to increase the number of RTMs to enable this all to occur effectively. This would enable the role to both undertake professional fieldwork supervision of staff and to have involvement with local organisations and community leaders at a more strategic and service development level.
Finding
Given the nature of the MOS Plus service itself (an outreach counselling and support service in remote communities in the NT), cultural competence and the service and staffing models are inextricably linked.Footnotes
20 O'Brien, W. "Australia's Response to Sexualised or Sexually Abusive Behaviours in Children and Young People" Australian Crime Commission ACC 2010