tracking high needs kids: out of sight, out of mind, and out of home care. centacare broken bay acwa...
TRANSCRIPT
Tracking high needs kids: out of sight, out of mind, and out of
home care.
Centacare Broken BayACWA Conference 2008
Dr Stephen Mondy Jean Murray
Senior ManagerProgram Development and Research
Senior ManagerOut of Home Care
Purpose of this talk:
Funding
Incumbent on providers to detail the programs they offer
Need for continued (longitudinal) research
Need for collaboration
Centacare Broken Bay
Professional welfare service delivery to Northern Sydney, Northern Beaches and Central Coast
12 Funding streams, 30 funding agreements and > 50 funded programs
Disability, Aged Care, Family relationships, Counselling, Mediation, DV support, Childcare, Respite, Employment, Housing support, SAAP, and OOHC
AUSTRALIAN OOHC TRENDS, 1983-2006
17,000
12,273
14,67715,674
16,92318,038
18,880
20,29721795
23,695
25,454
9,860
9,898
12,85914,323
15,701
16,861
17,82319,234
20758
22,601
24,199
7,140
2,4551,818 1,351
1,2221,177
1,0571,063
1037 1,0941,255
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
22,000
24,000
26,000
Nu
mb
ers
in C
are
Total in Care
Foster Care
Group Care
Adapted from AIHW Child Welfare Series and Bath (2007)
12,712 Children in OOHC NSW (June 2007)
30.4% of children in OOHC are Indigenous (Aboriginal/TSI) yet only 3.4% of NSW children are Indigenous
Residential careFoster careKinship care
2002 - 2008
$1.2 billion of additional NSW Government funding to strengthen child protection and care
Over $600 million for consolidating and extending OOHC services
An early component of this funding rollout was provision for residential care for young people with high and complex needs (‘High Needs Kids’)
Despite increasing resources the number of Children in OOHC in NSW continues to rise
Year Rate per thousand population
2003-04 6.2
2004-05 6.3
2005-06 6.7
2006-07 8.7
Secure units were closed in NSW in 1998
A small number of young people in care exhibit extremely challenging and risky behaviours to themselves and to others
Known as ‘High Needs Kids’ - acute, crisis-level of disturbance through self-harming and suicidal, violent or anti-social behaviour
Represent about 2% of children in care, but accounted for 26% of DoCS OOHC budget (in 2005-06)
NSW DoCS contracted four NGOs to work with High Needs Kids
224 placements across NSW
Centacare Broken Bay Broken Bay – 12 residential placements in 4 homes 6 foster care placements
Case management retained by NSW DoCS – placement service only provided by NGOs
Mostly adolescents with a history of residential and foster care placement disruption
Seriously challenging behaviours to self and others
Common diagnoses – ADHD, Conduct Disorder, Oppositional Defiant Disorder, Mood Disorders
Often fail to meet thresholds for intensive long term intervention by service systems - disability, mental health and criminal justice systems - yet still have complex child protection needs
Challenging behaviours - social/emotional difficulties:
• poor impulse control and/or stress intolerance • high risk-taking behaviours • alcohol and other substance abuse • poor self image • self-harming behaviours • social isolation/limited capacity to form relationships with peers/adults • sexually inappropriate behaviour • anti-social behaviours including aggression/violence towards people
In some instances: • criminal behaviour • mental health issues• physical health issues • intellectual disability • educational difficulties
Percentages of all Children in OOHC in NSW by number of placements (June 2007; n=12,712)
Number of Placements
Centacare Broken Bay HNKsDecember 2005 – present
Foster Caren=8
Residential Caren=23
Average # prior placements 2 11
Average age on entry (years) 13.4 14.7
Males (%) 63 43
Indigenous (%) 0 43
CALD (%) 50 8
Sibling in care (%) 63 25
Cost per child (today’s $ p.a.) 100,344 274,894
Educational/EmploymentPlacement (%)
63 31
Median Length of Placement (days) 432 408
Centacare Broken Bay HNKsExit Points
#n=13
Restoration home 2
Kinship care 7
Disability placement 1
Detention 1
Self placed 2
Small units (<3):• tailored programs• < iatrogenic effects
Staff
Recreation
PsychologicalAssessment
Training
Supervision
Small units (<3):• tailored programs• < iatrogenic effects
Staff
Recreation
PsychologicalAssessment
Training
Supervision
Small units (<3):• tailored programs• < iatrogenic effects
Centacare Broken Bay Integrated Services
DisabilityAged Care Family relationships Counselling Mediation DV support Childcare Respite Employment Housing support SAAP
Key features of Continuum of Care approach
• Staged entry and transitional arrangements
• A comprehensive individualised therapeutic intervention plan
• Staff move with the young person
• Recreational activities familiarise children with staff from future placements
• Risk minimisation approach to co-placement
Key challenges
Reducing placement disruption in community settings
• Site• Behaviour management• Neighbours
Attracting and retaining staff• Recruiting suitable staff• Vicarious trauma
Engaging with the education system
Key success factors
• Sufficient funding to meet each child’s needs
• Flexibility to redeploy staff to maintain attachments
• Close relationship with statutory case management agency (DoCS)
• Comprehensive individualised care plan
• Flexibility in young people’s participation in care planning
• Reconnecting young people with educational success
Implications for Practice
• continuum of care approach leads to enhanced placement stability
• offers the possibility of consistent, targeted therapeutic interventions that:
• address trauma • lead to the establishment of better attachments
and social functioning • stabilise behaviours contributing to placement
breakdowns
For more information please contact:
Jean Murray Senior Manager Out of Home [email protected]
Dr. Stephen MondySenior Manager Program Development and [email protected]