STATEMENT OF Bianca Bates

16 May 2019

Name Bianca Bates (professionally known as Bianca Smith)

Address

Occupation: Network Specialist Facilitator

On 16 May 2019, I, Bianca Bates, state:

1. This statement made by me accurately sets out the evidence that I would be prepared,

if necessary, to give in court as a witness. The statement is true to the best of my

knowledge and belief and I make it knowing that, if it is tendered in evidence, I will

be liable to prosecution if I have wilfully stated in it anything that I know to be false,

or do not believe to be true.

2. I have a Master of Education (Educational Leadership), Postgraduate Diploma in

Psychology, Bachelor of Education (Primary)/Bachelor of Social Sciences (Psychology),

Graduate Certificate of School Counselling, Graduate Certificate in Developmental

Trauma. I am a Registered Psychologist with the Australian Health Practitioner

Regulation Agency (AHPRA).

3. I have been employed by the NSW Department of Education (the department) as a

Networked Specialist Facilitator since January 2018. Prior to being appointed to that

role I have worked for the department as a School Counsellor (Registered Psychologist)

and before that as a Primary School Classroom Teacher.

4. As a Networked Specialist Facilitator (NSF), I support the strategic work of schools and

the department's School Services.

S. Working alone, no single individual or organisation can solve the underlying social,

health and economic issues that make it harder for some students to succeed at school.

Schools, families, service providers and government organisations need to work

Signature of Witness

Datil' 7

SCII.004.004.0001

together in an increasingly connected way to improve outcomes for our children and

young people.

6. As a NSF, I establish and maintain systemic, interagency relationships and build a

sustainable network of specialist support services for schools and an access point for

other agencies to connect with Education in regard to complex matters. Schools, with

the support of specialist staff, use the NSF to effectively and efficiently access and

coordinate interagency supports for students and families/carers, where and when

they are needed.

7. With School Services colleagues I support the coordination of resources to achieve

greater impact for and within schools, including the implementation of initiatives and

professional learning. I provide strategic leadership and undertake planning and

consultation with local education, interagency and community stakeholders and

interest groups to support the work of schools in supporting their students.

8. I work out of the Dubbo Education Office and am available to provide support to the

71 schools in the geographic area between Parkes, Wellington, Dubbo, Mudgee,

Coonabarabran, Brewarrina, Bourke, Coonamble, and Lightning Ridge. Approximately

17, 000 students attend the schools I work with.

9. I was asked to provide a witness statement to the Special Commission of Inquiry into

the Drug "Ice" addressing a number of matters identified by the Commission in a

letter to me dated 6 May 2019.

10. Wherever I have not had direct knowledge of a matter dealt with in this statement I

have relied upon information and advice provided to me by other departmental staff.

The approach the schools I work with take to drug education

11. I am aware that another witness is providing detailed information about the syllabus,

curriculum and teaching and learning resources so will only deal briefly with these issues

in my statement.

12. I am aware that drug education in NSW government schools reflects the whole of

government harm minimisation approach. It aims to promote resilience, and build on

knowledge, skills, attitudes and behaviours to enable young people to make responsible,

healthy and safe choices. Age appropriate drug education forms a part of the mandatory

I b.5. 11

SCII.004.004.0002

Kindergarten to Year 6 and 7 to 10 Personal Development Health and Physical Education

syllabus which is issued by the NSW Education Standards Authority.

13. Students in NSW government schools in Year 11 and/or Year 12 extend this learning

through the 25 hour mandatory Life Ready course.

14. The schools that I work with are able to access external providers to deliver age

appropriate drug education programs for students such as Life Education, who, in

partnership with schools deliver a curriculum based program to preschools, primary and

secondary schools. This includes a positive strength based approach to drug and health

education program delivered via a mobile learning centre.

15. However, in my professional experience, classroom teachers, with specific knowledge

of students and the learning context, are best placed to provide generalist drug

education. Although, external agencies have been engaged successfully on many

occasions in school settings to enhance existing drug education programs and respond

to individual school and student need.

16. As part of preparing this statement I asked some of the schools I work with whether

they are currently working with any external providers around drug education. I have

been advised that the following external agencies work closely with schools in the area

to provide individuals and cohorts of students with identified and targeted learning and

psychoeducation needs - headspace, local Aboriginal Medical/Health Services, NSW

Health, NSW Health School Link and NSW Police.

17. Agencies such as headspace often will present to cohorts of students in secondary

settings around wellbeing, mental health and drug education. Whilst not a specific

'program', as a result of working closely with Learning and Support Teams in schools,

external agencies are able to customise information to support each specific setting and

ensure connectivity with our young people.

ll:i. s.t 9

SCII.004.004.0003

Specific questions about Amphetamine Type Stimulants (ATS) including its prevalence

amongst students and their families, the impact on students and their families and school

communities of its use and

Whether the impact of ATS use is different from the impact of other drugs (for example

compared with alcohol, tobacco, cannabis and other illicit drugs

18. I don't know how prevalent the use of Ice is amongst the students that I work with.

However, I am able to comment specifically on my learnings from colleagues,

interagency partners and my own observations/interactions when working with young

people, their families and community.

19. In my professional experience as a Registered Psychologist, in both the NSF and School

Counsellor role, working regularly with young people, whilst the use of 'ice' may be

increasing in the communities I work with cannabis and alcohol are reported to me as

the more frequented substance by students in the schools I work with. Students have

reflected that this is because these substances are viewed more positively socially, less

invasive, easily accessible and perceived to be less harmful.

20. However, regular attendance as the NSW Department of Education representative at

the local Safety Action Meetings (SAM) and my involvement in the Operational Managers

Meeting (OMM) for the Family Investment Model (FIM) Multidisciplinary team illustrate

that the parental and community use is high in certain pockets.

21. My role in both forums is to provide an educational perspective into what are often

complex issues requiring a whole of government response to mitigate risk of harm for

our young people, their families and wider community stakeholders. The FIM OMM is

also a platform for managers within each government agency to review referrals that

have been submitted to the FIM team and approve the allocation of families to work

within this multidisciplinary cross sector team.

22. Reflecting on professional experience, observations, interactions with colleagues,

attendance at interagency meetings, professional learning and direct contact with young

people and their families, I have learnt ATS is readily available, cheap, and gives a

greater 'high' than other substances.

16 3' ./'

SCII.004.004.0004

23. I understand from my attendance at a number of interagency forums (i.e. SAM - where

incidents are discussed in detail to ensure a proactive service system response) that the

use of ATS comes with an increase in anti-social and maladaptive behaviour in the

community.

24. In my professional experience, from behaviours I have observed in young people and/or

their families, the effects of ATS include both the sought after effects, and negative

short-term and long term consequences. The impact of ATS can have both the intended

consequences ( outlined in paragraph 25 below) or adverse consequences ( outlined in

paragraph 26) depending on a number of factors including but not limited to the amount

taken, purity, physiological factors such as age and general health, individual tolerance

to the drug and the context in which the intoxicating effects are experienced.

25. For the drug user, in my professional experience (both through direct communication

and/or observation), ATS can provide an individual with a state of euphoria, mood

elevation, alertness, reduced fatigue, increased concentration, reduced appetite,

enhanced reflexes, perceived increase in confidence, energy, and reported increases in

physical strength.

26. Short term adverse effects that I have observed in young people and their families I

have had direct contact with at school indicating the possibility of an individual under

the influence of ATS would include restlessness, irritation, anxiety, agitation, reported

difficultly with sleeping, dilated pupils, parasitosis and profuse sweating.

27. For students the impact of a carer's substance misuse can be insurmountable on their

ability to access their education. In my professional experience, I know of students who

are up all night caring for their frightened siblings, no food in the house because money

has been spent on ATS.

28. This is evidenced often through interagency referrals for support, child wellbeing

reports, principals requesting support from the department's School Services personnel

around complex case management and also through my own direct interviews with

students and/or their families.

/(o.S.14

SCII.004.004.0005

29. I have also heard through my external agency network of an increase in reports of

students and family members prostituting themselves for money to purchase illicit

substances (including but limited to ATS) be it for themselves or others.

30. In my professional experience the impact ATS and other illicit substances has on families

is wide and varied. I have witnessed through my roles in the department that it has the

potential to impact a family financially, impact on a parent's capacity to care for their

children, issues pertaining to supervision, increased exposure to anti-social behaviour,

sexual and/or physical harm to young people given the increased adult presence at

times in the home (students often report a number of adults in the home together using

illicit substances), and higher risk of domestic and family violence.

31. Interactions I have had professionally with young people and/or their families who are

drug affected, have demonstrated the unpredictability of risk and behaviour from

individuals that are 'coming down' This is further supported by other agencies who

report through FIM and SAM that they are noticing trends and patterns of behaviour in

regards to how users are minimising the adverse effects of a 'come down'.

How schools identify a potential issue involving ATS use

32. Schools may learn of a potential issue involving ATS or more general illicit substance

use through the student voice, self-reports or from concerned family/community

members.

33. Principals at times have been able to report on specific circumstances when they are

requesting additional support from our School Services Team within the department.

However, more often than not, schools are notified by one of our external agency

counterparts that have significant involvement with the family (i.e. Family and

Community Services, Police, Juvenile Justice, Mission Australia etc).

34. This has been communicated via direct contact with the school, or other departmental

staff, or through an interagency meeting. This looks different in each community I work

in given the differences in resourcing and service provision each town has available to

them or is able to access remotely.

SCII.004.004.0006

anecdotal, informal

^

not^

35. However, key platforms to communicate include SAM and interagency Complex Case

Coordination (CCC) meetings (chaired by Family and Community Services).

36. Within a school setting, teachers and support staff are best placed to identify if a student

may be experiencing issues that require any kind of additional wellbeing support. Our

department has a priority to know, value and care for each student. Schools are able to

identify student wellbeing/welfare issues through the school's Learning and Support

Team, review of school level data, School Counsellor support referrals, external agency

involvement, and/or parent contact. Some schools have Clontarf and Girls Academies.

37. Possible wellbeing/welfare issues are also detected by the Education representative on

interagency meetings such as the SAM and CCC - associated planning and support for

the school and students can be provided as a follow up action to such meetings.

Supports schools provide to students, families and the broader school community who are

impacted by ATS

38. In my experience schools do provide support to students and their families impacted by

substance misuse by referring students and/or their families to agencies or individuals

that hold specialist knowledge and expertise.

39. In the first instance this will be through the Mandatory Reporting Guidelines and support

we can canvas from within the department's Child Wellbeing Unit if the issue does not

require a mandatory report to the FACS Child Protection Help Line.

40. Schools I work with often refer through the Family Referral Service (FRS) which is

funded by NSW Health so that families are linked in with appropriate supports in the

community as the FRS teams, where available, know the current provisions and

contractual agreements within the community.

41. In Dubbo, support includes intensive support referrals to the Family Investment Model

or through FACS completing a referral to the Multisystemic Therapy for Child Abuse and

Neglect (MSTCAN) team. MSTCAN is an intensive family preservation and restoration

model that targets causes of harm towards children.

SCII.004.004.0007

42. FACS have advised through their communication around this program that MSTCAN has

had success in addressing underlying trauma that may result from drug and alcohol

abuse and mental illness.

43. I am aware that some schools work with Mission Australia to complete a community

based referral to the Mac River Centre Residential Rehabilitation Program.

44. Mac River is located on the outskirts of Dubbo and supports young people aged 13-18

with chronic drug and alcohol issues who are willing to address their substance use. Mac

River provides inpatient residential drug and alcohol rehabilitation services to these

young people. I understand the residential stay in the program is 3 months, followed by

3 months aftercare.

45. Within the school setting, through the Learning and Support Team, school staff can refer

students with wellbeing needs to the School Counsellor and School Chaplains, Student

Support Officers and Year Advisors where available.

46. In addition, some schools have developed self-help and wellbeing hubs which are

physical spaces students can go in the school to access specialist support from resources

within and external to the department.

47. These spaces can include student and community access to targeted evidenced based

online mental health, drug and alcohol resources/platforms and in some spaces, a

visiting clinician from another agency (i.e. drug and alcohol worker, youth worker, sexual

health clinician, counsellor).

48. Schools also have models of check in /check out processes that include mentoring by a

known, respected and trusted staff member. These models are developed locally based

on student need.

Training and support provided by the Department of Education to school based staff to deal

effectively with students and families affected by ATS use

49. I am not aware of training for staff to deal specifically with those affected by ATS.

SCII.004.004.0008

50. Other than the curriculum and syllabus documentation pertaining to the educational

delivery of generalist drug education, resources are locally sourced based on

community/school need.

51. I am advised staff are briefed more in terms of how to respond in a crisis situation

referring to our department's emergency management and health and safety procedures

to keep the school community safe and Child Protection/Mandatory Reporting training.

52. I am also aware of a parent who was excluded from the school following repeated

aggressive and unpredictable behaviour on a school site. From personal observation, it

was evident that the parent was under the influence of an illicit substance and a police

response was required.

53. On occasion, I know of external agencies presenting to groups of staff around drug use;

however, I understand this is more targeted towards student use (i.e. headspace or

NSW Health Drug and Alcohol may present on the different types of drugs, drug trends,

the effect drugs have on young people and where to seek/refer for additional support -

although, nothing specially has been raised around ATS that I am aware of).

54. The department's school counselling service provides staff training around topics such

as trauma and mental health issues that may be a manifestation of drug use; however,

to my knowledge they do not provide any training specifically around ATS.

55. The department recently held a Wellbeing forum in Dubbo for 750 school staff in the

Western Region on the Term 2 staff development day with a number of expert speakers

addressing topics of, positive education, trauma, mental health, managing complex

behaviours, sensory classrooms, and sustainable healing in Indigenous culture. A copy

of a flyer for this forum is attached to my statement at Annexure A.

56. Hosting training days such as these provides staff, regardless of geographic location

with the opportunity to access quality professional learning to support students in their

settings.

How schools work with other agencies and services, including drug rehabilitation and

treatment services, to support students and families impacted by ATS

SCII.004.004.0009

57. The schools I work with work closely with external agencies to support students and

families impacted by substance misuse, including ATS. Knowing that we are not the

'experts' in this field, schools rely on relationships and connections with external

agencies to link families in with appropriate, evidence based support.

58. As mentioned above, schools and support staff, including School Services for example

the NSF have opportunities to work with the Mac River Rehabilitation Centre to provide

support to young people who are willing to address their substance use.

59. The Lincoln School (Lincoln Education Training Unit, a NSW Department of Education

school within the Orana Juvenile Justice Centre) provides the face-to-face onsite

education provision to the students accessing the Mac River program (run by Mission

Australia). This has been a recent initiative undertaken by the department and I

understand there have been improvements in school engagement for students whilst

accessing the Rehabilitation Centre (Lincoln School provides both the education program

within the justice centre, and the provision onsite at Mac River. Teachers travel between

worksites to ensure consistency for students).

60. The young people at Mac River are often already known by the staff from the Lincoln

School from a time the young person may have spent in custody. Where a pre-existing

relationship exists, this can be a protective factor to a young person's engagement in

the rehabilitation program, their access to schooling whilst at the rehabilitation centre,

and their successful transition back to their community, school, and/or alternate

program at the completion of the program. This initiative from the department has

meant that although there may be a number of changes in the young person's life,

Education is able to remain a stable and protective factor.

61. The Lincoln School communicates with the student's 'base school' around individualised

learning and support needs of each student so that the transition is as smooth as

possible for the young person.

62. This often includes complex case meetings with School Services personnel (Learning

and Wellbeing Team and NSF) if the young person is likely to require additional support

in terms of intensive risk and behaviour management planning, a Support class (smaller

class setting with Special Education Faculty) or Integration Funding Support for an

/io.S-l9

SCII.004.004.0010

eligible student in a mainstream class environment. The school learning and support

team and school counselling service are pivotal in this process.

63. I have been contacted by the local NSW Health Drug and Alcohol - Project Officer Youth

Drug & Alcohol Clinical Support Network who is leading a project around a proposed

model of how to engage with schools to support them in engaging young people with

drug or alcohol dependence. I understand this project may serve as a triage service to

the most appropriate referral source. An outline of the early stages of the model

presented to myself and another NSF colleague at Annexure B.

Barriers faced by schools in meeting the needs of students and their families impacted by

ATS, and how these barriers can be addressed

64. Schools often do not know for sure if a student and/or their family are impacted by

substance misuse including ATS. The information they may have is gathered anecdotally

from externally sources (be it providers, agencies or through interagency meetings such

as SAM or CCC).

65. At times, given capacity and resourcing constraints of other agencies, referrals for

additional supports are not allocated. I have been told this can occur because a case

does not meet the threshold for allocation or response. This can be frustrating for school

staff who are following processes in terms of Mandatory Reporting where they have

ongoing child protection concerns.

66. Given that young people are engaged in education up until the age of 17, staff can see

the longitudinal impact ATS use can have on their ability to access their education and

successful lifelong outcomes.

67. It is my understanding that in some rural settings, families may need to travel to a larger

town (like Dubbo) to access support. This is not always feasible or possible for some

families who experience high levels of disadvantage and do not have access to transport.

I am also aware that there are community factions in some areas which has an impact

on what services some families are willing to access to get support.

68. In my professional experience, I know that some families do not take up offers of

supportive referrals (re: substance misuse and wellbeing conce~ external agen,c~ie~s'-../----'

,/4.,,,,b~ U

SCII.004.004.0011

and sometimes child protection concerns can escalate and schools, rely on statutory

child protection bodies to provide a response where there are imminent safety concerns

for a young person.

lbs.1ci

SCII.004.004.0012

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~· NSW GOVERNMENT

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SCII.004.004.0013

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SCII.004.004.0014

4'1. NSW GOVERNMENT

Health B Western NSW Local Health District

YOUTH DRUG AND ALCOHOL CLINICAL SUPPORT NETWORK

The Youth Drug and Alcohol Clinical Support Network (YDACS Network) consists of a number

of service providers working together to deliver a range of interventions for young people

(aged 10-18 years) with drug and alcohol dependence. The Network will include the

establishment of a specialist team of clinicians with expertise in drug and alcohol that will:

• build the capacity of service providers to engage with youth and deliver a range of

developmentally appropriate, evidence-based drug and alcohol interventions;

• work in partnership with service providers to deliver screening and assessment,

clinical consultation and review, and shared care coordination and treatment for

young people with moderate to severe substance dependence; and

• be primarily virtually based so that services can be provided more equitably across

Western NSW Local Health District (WNSWLHD) using telehealth technology.

Care and treatment delivered through the YDACS Network will be holistic, trauma informed,

age appropriate, family centric and culturally safe for young people experiencing drug and

alcohol addiction. Strong partnerships and referral pathways between WNSWLHD and local

NGO organisations will underpin the delivery of the YDACS Network (refer Figure 1 below).

Figure 1: YDACS Network Model of Care

SCII.004.004.0015

~-• NSW GOVERNMENT

Health Western NSW Local Health District

A stepped care approach will be applied so that different levels of treatment are offered

based on the complexity and acuity of the needs of the young person presenting. The

specialist team of youth drug and alcohol clinicians will be available to provide advice,

support and capacity building to service providers to deliver interventions across the

spectrum of treatment options appropriate to their organisational capacity. The team will

also provide direct treatment to young people, supported by a local support person, for high

acuity clients where no appropriate local service is available - refer Figure 2.

Types of Treatment Provided across the network

YDACSN Team to PROVIDE TREATMENT for higher acuity clients where there is no available appropriate service

YDACSN Team to BUILD CAPACITY of service providers to deliver treatment options appropriate to their organisational capacity

..... Individual

C Q)

..... Self Help Q)

C: Guided Self ro Help E ..... Brief ro

Q) Intervention ,_

I-Motivational > Interviewing :!:::

VI

Therapy E Family Inclusive .....

ro Therapy Q) ,_ residential I-Rehabilitation or > day program :!:::

VI

GP led C: Q)

ambulatory ..... withdrawal C:

Short-Term C: Q)

Care +-' C:

Coordination 5 0

__J

Case E Management ::,

Short-Medium "'C Care

Q)

Coordination and ~ ongoing engagement

Intensity of Treatment

Figure 2: Stepped Care Approach

..... C:

Medical a; Intervention E Opiod Treatment 1i:i Program ~

Hospitalisation I-

Intensive Counselling/ Multisystemic therapy

Detox/ withdrawal management (inpatient, outpatient, community)

Medium - long term facilitate care coordination and nogoing engagement

> :!::: VI c:: Q) ..... C:

....c::

.9fl I

Young people will be able to access support and treatment through various service

providers in the Network, with referral pathways in place amongst local services. A flow

chart outlining the role of the specialist team and other service providers in providing

support and treatment to patients is at Appendix A.

The model of care will be implemented through a phased approach, with initial

implementation in three pilot sites across regional and remote communities. Learnings from

the pilot sites will inform broader implementation of the YDACS Network across the District .

SCII.004.004.0016

~· Health Western NSW NSW

GOVERNMENT Local Health District

CAPACITY BUILDING

Capacity building activities will leverage off the existing skill sets of staff already engaging

with communities. A range of tools, resources and training and education opportunities will

be coordinated and delivered by the VDACS Network specialist team, guided by a Capacity

Building Framework. Activities will focus on building skills and confidence of staff in:

• engaging with young people;

• working with families;

• screening and assessment processes;

• providing trauma informed, culturally safe care;

• delivering evidence-based drug and alcohol interventions;

• harm minimisation;

• referral pathways; and

• using telehealth.

STAFFING

The specialised team of clinicians will be recruited to support the functions of the VDACS

Network and will operate 5 days a week {Monday to Friday), 8 hours per day. The team will

comprise of the following:

• Clinical Team Leader {1 FTE)

• Nurse Practitioner (.5 FTE)

• Clinical Nurse Specialist (.5 FTE)

• Mental Health/ Drug and Alcohol Clinician with experience in psychosocial

interventions such as a Psychologist, Social Worker Level IV, or Counsellor (1 FTE)

• Family based worker (delivering services face to face) (lFTE)

LINKS WITH EXISTING HELPLINES

A number of existing drug and alcohol helplines will complement the services delivered

through the VDACS Network. These helplines include:

• Alcohol and Other Drugs Information Service (ADIS), which provides 24 hour, 7 day a

week telephone counselling, support, referrals and information for those affected

by alcohol or other drugs (Ph: 1800 250 015);

• WNSWLHD Drug and Alcohol Helpline, which provides an intake service for referral

to drug and alcohol services during business hours, including triage for follow up by

the respective referral service (Ph: 1300 887 000);

• Family Drug Support 24/7 Support Line, which provides 24 hour, 7 days a week

telephone counselling, support, referrals and information to families impacted by

someone's drug use (Ph : 1300 368 186); and

• NSW Drug and Alcohol Specialist Advisory Service (DASAS), which provides advice to

health professionals on the clinical diagnosis and management of patients with drug

and alcohol related problems 24 hour/ 7 days a week (Ph: 1800 023 687).

IL. .'.\. i~

SCII.004.004.0017

t' t C

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.r,,. ~-~ NSW GOVERNMENT

Health Western NSW Local Health District

~tk NSW GOVERNMENT

APPENDIX A - SERVICE FLOW CHART ACROSS THE CONTINUUM OF CARE

Initial Contact Screening Assess/ Plan/ Treat/ Review ) Ongoing Care Coordination

Aboriginal Health Worker/ AMS

Community Organisation or NGO Referral Service

Schools and School-Link Officers

Head space

Vocational and Further Education Providers

G Ps and Private Allied Health Practitioners

WNSW LHD D&A Service

-\ ~ }(~

~ Medium to High Intensity MH

Service e.g. CAM HS

Police --

~ Emergency and Acute or

Community Health Services

Mandated Services (JIRT, JJ, CP)

YDACSN Team provides advice, screening tools, education, brokerage and information to Screening Organisations and supports linkages to Assessment/Treatment Organisations

--

Screening Organisation provides initial

Assessment and /or Treatment/Intervention

I YDACSNTeam provides

advice and capacity building to

organisations and direct assessment/ treatment to young

people via telehealth in remote and un­serviced areas

I Screening Organisation

refers to other Assessment/ Treatment

Organisation

Treatment Organisation in partnership with Young Person and

Family/Carer and other Care Coordination

Providers as appropr iate to identify,

goals, next steps, suitable care coordination

arrangements, and ongoing review

YDACSN Team provides direct care

Coordination in collaboration with local

organisations via telehealth in remote

and un-serviced areas

~ ---

\.

Young Person recovers and exits care with support and assertive

follow up by care Coordinator or Service Provider

_ii

Health Western NSW Local Health District

4

SCII.004.004.0018