Do you feel safe in your relationships? Alpine Health staff will now be asking this of every patient they see.
This question is the first step in a new screening process for family violence, which has come about as a result of the Victorian Royal Commission into the issue.
But it’s not a simple case of ticking a box and moving in.
If a person answers ‘No’, staff will make a note of that and check again later – their patient might not feel ready to disclose the first time, but perhaps on the fifth occasion they will.
If the answer is ‘Yes’, a series of questions will enact what’s referred to as ‘sensitive inquiry’.
This process falls into The Strengthening Hospital Responses to Family Violence (SHRFV) initiative, responding to recommendation 95 from the commission.
Royal Women's Hospital and Bendigo Health were funded by the state government in 2014 and 2015 to develop a framework “for identifying and responding to family violence experienced by patients”.
Alpine Health launched their SHRFV model this week and project leader Lisa Neville said the statewide program was best practise.
“This toolkit allows you to develop it for your own hospital,” she said.
“For Alpine Health, we’ve decided to take a whole-health service approach, as opposed to other hospitals that service many more people and might just do maternity wards and their emergency wards.
“Because our staff work across so many different fields and areas, it was really hard to outline the delineation of ‘No you don’t deal with that client’.
“And because we have an ageing population in Alpine Shire, it’s really important that we’re looking at family violence across the whole age span.
“We don’t expect our staff to be family violence experts, but be want them to able to recognise the signs, inquire sensitively, and refer on to the appropriate services.”
Taking into account that one in four Australian women have experienced physical or sexual violence by an intimate partner, Alpine Health also has internal checks and support in place.
“We want to support any of our staff experiencing family violence, and those who are not necessarily experiencing it right now,” Ms Neville said.
“We’re asking our staff to screen for family violence and do sensitive inquiry, and they might have actually experienced family violence in the past too, so being able to support them adequately through that inquiry process is paramount.”
Alpine Health joins Mansfield District Hospital, Benalla Health and Yarrawonga Health as a group of Central Hume health services that have a shared position statement to work together on the issue.
Last year, Northeast Health Wangaratta was given the role of supporting the implementation of SHRFV across the Central Hume services.
A project officer was employed to roll out the model.
Community health, partnerships and well ageing director David Kidd said NHW worked extensively with appropriate services including Centre Against Violence and the Victorian police force.
“To date Central Hume health services have been supported to engage a project officer on the ground, and have been provided training and support in policy development to add to their already extensive local networks and activity,” he said.
“This financial year we are adding social work support across the area for the health services to access as well.
“At NHW all management staff have been trained in family violence identification and response, and staff training is ongoing to train all staff in family violence identification.
“Staff such as social work and key HR staff have been training in immediate response and staff support.”
In May, SHRFV was launched at Albury-Wodonga Health, and at the Beechworth, Corryong and Tallangatta health services.
Each organisation has created a web or intranet site that provides staff with contact details and simple steps to follow in the event they suspect or become aware of family violence issues with a patient or a colleague.
With a significant funding boost for the second year of the project, AWH and partner health services have kicked off plans for the next phase.
While training of staff continues, there will be an increased focus on building partnerships between community groups and service organisations.
It’s clear across all health services in the North East region, the response to family violence is stronger than it’s ever been – though many have been working in their own way to combat the issue for decades.
Ms Neville, who has been focusing on prevention for 10 years, said Alpine Health’s previous work included implementing guidance in parenting groups.
“It’s starting from that really early point when a couple become a family, and are making choices about roles and responsibilities in that family unit, to plant the seed around gender equality,” she said.
“It’s a privilege to work in this space and slowly chip away at cultural change.
“With 227 recommendations from the royal commission, it means across all the different spectrums of work and society there is something being implemented to address and redress family violence.”
In launching the new model on Wednesday, Alpine Health chief executive Lyndon Seys urged the community to have a conversation.
“One of the things we’re trying to do is bring the issue out into the open so it’s no longer stigmatised, and treat it as a health issue,” he said.
“Let’s think about what our society would actually look like if family violence didn’t exist.”
Implementation of recommendation 95 from the commission, “Implement a whole-of-hospital model for responding to family violence”, is forecast to be complete by the end of March, 2021.
As at May this year, 27 health services had been funded to implement the SHRFV model and more than 4000 doctors, nurses and hospital support staff had undergone training.
The fourth edition of the SHRFV Tool Kit is due for release late this year.
A spokesman for Health Minister Jill Hennessy said all North East health services were rolling out a new model.
“Our hospitals and health services are leading the way, with staff able to access up to 20 days of family violence leave,” he said.
Refuge being rebuilt in Wodonga
Land will soon be purchased for a women’s refuge in Wodonga, as initiatives put forward by the Royal Commission into Family Violence are delivered by the state government.
Recommendation 15 outlined existing communal refuges should be phased out and replaced with ‘core and cluster’ properties that promote safety, are accessible to people with disabilities and provide connections to community, school and work.
Centre Against Violence chief executive Kerry Burns said 17 refuges across the state, including one for the Ovens Murray area, were being rebuilt to increase capacity and make them more inclusive.
“We expect it to be a four-unit property in Wodonga, which will definitely improve the care available to vulnerable women and children, and enable them to live safely in the community,” she said.
“If they are comfortable, in a unit there might be four women and their children, or if we get a big family group, the units are designed to allow a woman and six or seven children.
“We’ll keep some of our current model, which is what we call dispersed; women are safely housed in a house or unit in towns across our district and are living independently but with intensive care from us as well.
“Our intention is to purchase land for this project by December, and to be building our refuge in 2019.”
Ms Burns said nine staff had been employed to deliver new projects including in training students and supporting the drug and alcohol sector.
“What we have achieved so far this year in response to the commission is we have enhanced after hour services, and while we always responded 24/7, we now have a dedicated team leader leading care for women at high risk from Friday to Monday,” she said.
“We’re scheduled for the safety hub in 2020, we’re preparing for that now through strengthening partnerships with Upper Murray Family Care and Gateway Health.
“It’s a wonderful time to be practising in our field.
“The range of the reforms is vast – the government is thinking about clients, strengthening professional effectiveness, and physical resources that are needed, it’s very innovative.”
A government spokeswoman said funding had also been provided for private rental housing access, flexible support packages, and to purchase 10 properties to help women and children escaping family violence.
The current refuge will continue to operate until the new facility is built.
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