Chapter 4: Service providers' experiences of the family violence service system

4.1 Introduction

This chapter summarises key themes emerging from the literature on how specialist NGO service providers experience the family violence service system. Following on from the previous chapter we look at what supports service providers require to deliver accessible and effective services to improve the safety and wellbeing of families and whānau effected by violence.

We also examine how government and NGO services collaborate and work together to deliver a more holistic and informed approach to manage risk and meet the needs of families and whānau. These initiatives aim to address issues identified with service access, referral pathways, information sharing and service coordination.

4.2 Kaupapa Māori providers’ experiences of the family violence service system

4.2.1 Key issues for kaupapa Māori providers

The following key issues impacting on kaupapa Māori service providers were identified in the literature:

• Experiences of government commissioning and funding of social services:
  • promoted an adversarial contracting environment which often under-resourced (or withheld resources) for Māori initiatives and/or were not commensurate with the burden of need experienced by whānau;
  • funded single-issue, individually focused programmes and initiatives and provided limited resources for preventative and long-term ‘whole of whānau’ initiatives;
  • had stringent regulatory monitoring and assessments based on deficit measures and indicators;
  • had competitive contracting that discourages collaboration and expected that under-resourced Māori initiatives achieve outcomes within short time frames, while government agencies with family violence as part of their portfolio continued to underperform and/or achieve outcomes for Māori; and
  • successful Māori programmes were at risk of being appropriated into mainstream delivery and as stated previously, would be implemented in a ‘piecemeal’ way.
• Research from Te Puni Kōkiri suggests the need for more ‘by Māori, for Māori’ (kaupapa Māori) services has been hindered by a system that privileges western frameworks and approaches over mātauranga Māori (Māori knowledge).
• Other literature shows that mainstream organisations and agencies working with whānau are not well-equipped to recognise or respond to the specific needs of Māori and whānau, can lack empathy and, as a result, can re-victimise whānau.
• Family violence is a specialist area and requires a specialist skill set that includes an understanding of the complexities of violence and also the burden of historic and complex trauma on Māori and whānau.

4.2.2 Treaty-based practice approaches

The research shows that using Treaty-based practices and decolonising services would address some of the structural inequities caused by basing family violence support practice on the standards/norms of the dominant group. ‘A large and growing evidence base shows the benefits of kaupapa Māori services and reclaiming mātauranga Māori’ (Family Violence Death Review Committee, 2020, p. 16).

The historical and ongoing impact of colonisation, which includes unchecked privilege, and how colonisation contributes to chronic and complex trauma for both individuals and communities … are central reasons why Māori and non-Māori experience violence across generations. Addressing these issues requires an honest partnership between the Crown and Māori, leading to decolonised services and measures that address structural racism. (Family Violence Death Review Committee, 2020, p. 16.)

Having Māori representation at all levels of decision-making in the family violence system is extremely important because ‘Māori per capita continue to be over-represented in family violence statistics as both victims and perpetrators’ (Rudman et al., 2017). Berghan et al. (2017) found widespread agreement in their study about the importance of Māori representation at all levels of decision-making – from needs assessment to concept development, planning, delivery, and evaluation. Berghan and colleagues (2017, p. 24) recommend the following action points for service providers:

• Ensure Māori are involved in all decision making
• Ensure recruitment processes reflect and value cultural competencies
• Encourage the active retention of Māori staff
• Open professional development opportunities to Māori partners
• Work with existing governance teams to promote understanding, value the necessity of such appointments and resource appropriately
• Commit resources to prepare Māori for leadership roles.³⁹

4.3 Elder abuse services experiences of the family violence service system

The Ministry of Social Development’s 2019 review of the current state of elder abuse care, in which its family violence team engaged with 15 Elder Abuse Response Services (EARS) throughout Aotearoa, found that, in addition to general issues of under-funding and under-resourcing, the EARS providers were concerned about problems arising from the overall system of service provision – ‘the external system’. They were concerned about how these issues impact their ability to successfully support people experiencing elder abuse.

Many services, such as housing, social connection programmes, in-home support and home visiting services are not consistently available throughout Aotearoa. They are particularly lacking in rural areas, which limits the extent to which the EARS providers can ensure that the older people they are working with feel connected and safe. Furthermore, the long waitlists and strict criteria occurring because of the high demand for mental health services throughout the country serve as barriers to older people needing to access these services.

Issues of workforce capability among agencies were also raised in relation to recognising risk factors and appropriately responding to elder abuse, as well as understanding older people’s rights and the effects of ageism. The EARS providers consider the lack of awareness a high-risk factor and recommended that all agencies who interact with older people undergo more rigorous training in these areas.

Additionally, the EARS providers cited the siloed nature of operations between and within government, private, and community agencies as adversely affecting communication and coordination, resulting in either duplication or gaps in services. Furthermore, they ‘highlighted the exploitation of older people by agencies (particularly government agencies) as part of their operations’. Examples of exploitation include ‘putting mokopuna and parolees in older relatives’ care without undertaking appropriate assessments and providing resources to ensure all parties are safe and supported’ (Ministry of Social Development, 2019a, p. 24).

4.4 Providers experiences of commissioning and funding of services

The Productivity Commission’s review of social services in 2015 identified eight fundamental causes for under-performance in the system at that time. It is worth quoting these issues because the experiences of specialist providers (NGOs who provide specialist services for family violence, sexual violence and children’s and young people’s services) rely heavily on government commissioning of services. The eight fundamental causes were:

1. Government commissioning of services happens in silos, with each silo evaluating the need for services through its own specialised lens. No agency has an understanding of (or accountability for) the holistic needs of clients, and users of the system must navigate their way through multiple administrative processes.
2. Incentives in the system drive prescriptive contracts, contracts of short duration and onerous reporting requirements. These features work against innovation and inject unnecessary transaction costs into the system.
3. A lack of agreed measures of value inhibits knowledge about the impact of services. Commissioning agencies all too often are unable or unmotivated to redirect resources to more effective services and providers.
4. Government decision makers have limited information on the combination or sequencing of services required by clients. The effect is that service specifications are too rigid to meet the needs of clients – particularly those with multiple and complex needs.
5. Weak government stewardship of the supply-side of the social services system has contributed to the precarious financial position of some providers, an over-reliance of some agencies on particular providers, and providers often lacking the resources to invest in staff training, innovation and evaluation.
6. Unsophisticated commissioning has resulted in formulaic procurement that is ill-suited to the complexity of social-services. There is a limit to the gains agencies can achieve by improving contracting out.
7. Short-termism has led to missed opportunities in prevention and early intervention, escalating fiscal costs in the future.
8. Funding and managerial inertia obstructs system improvements. (Productivity Commission 2015, p. 86)

In 2019, Social Service Providers Aotearoa (SSPA) commissioned MartinJenkins to conduct research and economic analysis to quantify the funding gap faced by social service providers and offer recommendations on how to improve the funding model.⁴⁰ MartinJenkins made 39 recommendations to be implemented in the short, medium and long-term. The headline finding stated:

This research has found that the social service system in New Zealand is not working as well as it could be and that, as a result, providers delivering critical services to those in need are under-funded and over-reliant on the philanthropic sector.

Results indicate that currently the government funds providers for less than two-thirds of the actual cost of delivering the essential services they are contracted to provide, and that the total underfunding is estimated to be at least $630 million annually. (MartinJenkins, 2019, p.6)

This report identified the following drivers of the funding gaps:

A historical preference for partial or contributory funding models for devolved essential government services. This is opposed to a default, or first principle, where essential services are fully funded as if they were being delivered directly by a government agency.

…Government funders prefer to invest in more generous funding packages for new services, which put established services at a disadvantage. Existing service contract funding remains steady over time, meaning the real value of their contract is in decline.

There is a focus on driving efficiency and effectiveness across social services …. which drives adverse funding behaviour, meaning providers do not have the funding or the flexibility they require to best meet service users’ needs.

There is limited agreement across the social service system as to what funding will achieve and what ‘good’ looks like. There is limited information-sharing and learning, and the information that is captured is seldom used systematically to guide funding decisions. (MartinJenkins, 2019 p.9-10)

The Ministry of Social Development (MSD) has recognised the need to improve the way they fund family violence services and has recently developed a new funding approach in consultations with providers. In 2019 MSD contracted almost 200 family violence providers based on a contributory funding model. They are the major government funder of victim services accounting for 85 percent of the government’s total spend. MSD contributed less to perpetrator services (15 percent of the government’s total spend), with other agencies such as the Ministry of Justice and Department of Corrections also funding perpetrator programmes (Ministry of Social Development, 2019b, p.8). MSD consultations with providers identified the following interrelated issues with the current funding and commissioning model:

• Primarily fund crisis services (around 90 percent) due to demand which means there is limited funding for prevention and longer-term recovery work.
• Focus on short-term interventions of less than 15 weeks does not allow time to work with families and whānau to overcome their trauma and break the cycle of intergenerational violence.
• Funding focus on programmes which tends to be inflexible and does not allow providers the scope to tailor approaches to meet complex needs of service users.
• Issues with the contributory model of funding and contracts not accurately reflecting the reality of the providers’ workloads.
• Onerous reporting requirements associated with having multiple contracts with multiple government agencies, which ask providers to report on different measures, with different reporting periods.
• The current contracting of services creates a highly competitive environment for organisations which can cause tensions in the sector.
• Short-term contracts do not allow for longer term planning and can cause staff recruitment and retention issues.
• Output based contracts do not have meaningful outcome measures that lead to understanding service effectiveness for supporting families and whānau to become violence free.
• Once case closed no funding or requirement to sustain engagement and support longer-term outcomes. (Ministry of Social Development, 2019b)

MSD also note there is wide variance across the country and within funding lines as to how much they fund providers for specific services. To address these issues MSD is developing a new model that is based on the following four key enablers to drive positive changes:

1. applying fair funding;
2. encouraging a diverse mix of family violence providers, including kaupapa Māori and Pacific providers;
3. committing to continuous improvement; and
4. working with providers to improve outcomes over time.

MSD state their priorities for the future include:

• having a whānau-centred approach to service delivery;
• setting sights on long-term recovery;
• giving our communities universal support, how and when they need it; and
• giving our regions more support.

The MSD report Social Sector Commissioning: Progress, Principles and Next Steps (2020)⁴¹ further sets out how MSD plans to improve their commissioning of social services and partner with NGOs and the community sector. MSD state this report is a response to conversations with the social sector so far and the next steps that will be taken towards a better system that supports better outcomes:

Progress towards a better system has begun. This includes more sustainable funding models, client and whānau-centred design and innovation, supporting community-led initiatives, longer term contracts, simplified contracting and procurement processes and partnering with iwi and Māori communities. However, we know that there is still much more to do. (Ministry of Social Development, 2020, p.4)

MSD is taking a new approach to commissioning social services, which includes family violence service providers.

4.5 Supporting service provision and good practices

4.5.1 Service approaches to meet needs of service users

To meet the diverse and often complex needs of families and whānau affected by violence, many studies recommend tailored approaches based on comprehensive risk and needs assessment; case management and advocacy approaches to navigate and coordinate between services; and responsive approaches to work with unique needs of different populations (Allen and Clarke 2017b; Carswell, Frost, Moana-o-Hinerangi, & Betts, 2017, Chetwin, 2013; Family Violence Death Review Committee, 2020; Lambie & Gerrard, 2018; Ministry of Justice, 2017; Roguski & Gregory 2014; Polaschek, 2016).

For example, Chetwin’s (2013) review of effective interventions for adult victims and children found:

strong evidence that an integrated and collaborative system response is most effective in reducing victims’ and children’s exposure to intimate partner violence; and that integrated mother/child interventions are highly effective in assisting them to deal with the impacts of violence. It is clear that no single intervention will be sufficient. A variety of integrated and co-ordinated interventions are required to meet a variety of needs.’ (Chetwin, 2013, p.5)

Polaschek’s (2016) issues paper about responses to perpetrators of family violence also identified that an integrated response system is required that includes subsystems for perpetrators, victims, and families. This system should be designed from the service user perspective and encompasses crisis to longer term supports until change is firmly established. An integrated perpetrator subsystem ‘includes co-ordination between crisis response and immediate containment, criminal and civil court proceedings, sentence or order compliance, risk monitoring and behaviour change components, and provides services based on risk and need’ (Polaschek, 2016, p.1).

4.5.2 Workforce capacity and capability

Workforce capacity and capability issues are identified in a number of the studies as a critical area that requires more focus. To our knowledge there is no national strategy or monitoring of how workforce capacity and capability issues are being addressed. This section briefly outlines some of the emerging findings.

Workforce capability

A crucial element of ending family violence and child maltreatment is a well-trained workforce, well-supervised to conduct evidence-based, cultural appropriate interventions in homes, schools, NGOs, statutory agencies and the community. (Lambie & Gerrard, 2018, p.34)

Lambie and Gerrard (2018) state there is need for resources aimed at teaching trauma-informed skills to NGO and statutory sectors that may interact with families and whānau affected by violence. Alongside an understanding of the effects of trauma and how to respond, it is also important that workers have the appropriate level of knowledge for their role about the dynamics of family violence, sexual violence and child maltreatment. For example, research has shown that having skilled programme facilitators with a nuanced understanding of the dynamics of family violence, especially those with a lived experience of family violence, is key to securing participant’s engagement with programme content (Family Violence Death Review Committee, 2020; Paulin et al., 2018). In the field of family violence, it is not only crucial to have the right level of capability for each role, but the personal qualities of the individuals fulfilling the roles is equally important. For example, being empathic and having high levels of emotional intelligence (Campbell, 2014; Carswell et al., 2017).

Studies emphasise the importance of service providers and their workforce being culturally competent and understanding and reflecting the communities they serve. This has implications in terms of recruitment and supporting staff capability to engage and work with diverse groups, such as Māori, Pacific Peoples, other ethnicities, people with disabilities, the elderly, and the LGBTQIA+ community, (Carswell et al., 2019; Fa’alau & Wilson, 2020; Fanslow & Kelly, 2016; Foote et al., 2015; Lambie & Gerrard, 2018; Ministry of Social Development, 2019; Pihama et al., 2016; Te Wiata & Smith, 2016; Va’afusuaga McRobie, 2016; Waldegrave, 2015; Wharewera-Mika & McPhillips, 2016).

Professional supervision (including clinical supervision and cultural supervision) is another important area to consider for supporting practitioner’s capability through reflective practice and strategies to mitigate the impact of vicarious trauma.

In 2017, the government published The Family violence, sexual violence and violence within whānau: workforce capability framework (Rudman et al., 2017). The framework aims to guide a ‘consistent, integrated and effective response to family violence and sexual violence’. As stated, the framework recognises the importance of building the capability of the wider workforce, so victims and perpetrators get an appropriate response and there is a more integrated approach between organisations.

The Workforce Capability Framework is divided into six domains:

1. Understanding people’s experiences of family violence, sexual violence and violence within whānau
2. Upholding the dignity, values and beliefs of people and their diverse cultural identities
3. Enabling disclosures and response to help-seeking
4. Using collective action to create safety for victims
5. Using collective action to sustain safe behaviours of perpetrators
6. Working as part of an integrated team.

Each domain addresses the knowledge required, examples of ‘excellence’, and the required actions in relation to specific roles, for example, primary/specialist practitioners. Career Force delivers the New Zealand Health and Wellbeing diploma in Family Violence, Sexual Violence, Violence within whānau (Level 5) that applies the workforce capability framework.⁴² Further research would be required to assess to what extent the framework and diploma are guiding capability building and consistency of practice, particularly given the diversity of the workforces and range of professional qualifications.

Alongside the Workforce Capability Framework, the Government published the Family violence risk assessment and management framework: A common approach to screening, assessing and managing risk, in 2017. This was developed in consultation with providers and aims to provide a collective approach for responding to family violence, a shared understanding of family violence and its dynamics, and clear values that underpin good practice in risk assessment and management. The uptake and implementation of this framework is not known.

There are a number of training providers that provide workshops and courses about specific areas of family violence, sexual violence and child abuse and neglect.⁴³ There currently only appears to be a postgraduate option for tertiary education specifically about violence prevention and no undergraduate degrees.

The New Zealand Family Violence Clearinghouse provides an information service, library, monthly pānui, data summaries, issues papers, and hosts webinars, seminars, workshops, and conferences. Networks of specialist services and the government have published a number of good practice guidelines for different types of specialist services and to guide working with different population groups.

Workforce capacity

Family violence services require sufficient staff/kaimahi in the right roles to meet the needs of service users. As outlined above, family violence services often struggle to obtain enough funding to meet the demand for their services. The limited resources and short-term funding contracts reduce providers’ ability to recruit and retain suitably qualified staff. Coupled with the high demand for services this can lead to high caseloads and waiting lists.

Researchers have found that burnout and stress are strong predictors of staff intention to leave. This is particularly salient for the family violence/sexual violence/child maltreatment field which is particularly demanding. Losing skilled and experienced staff can disrupt the quality and capacity of the service as well as having a negative impact on the workload of the remaining staff which in turn can intensify feelings of burnout and stress (Thomas et al., 2020 n.p.)⁴⁴ Having supportive employment policies and processes is key to recruiting and retaining quality staff (Carswell et al., 2017a).

4.5.3 Consistent implementation of good practices

Related to the above discussion on resourcing and workforce capability and capacity are considerations of organisational capability to support their staff/kaimahi to consistently implement good practices in their daily work. The area of implementation science specifically focuses on the ‘how’ we can transfer knowledge into practice as Lambie and Gerrard describe in their discussion paper:

“Implementation science” explores the ways we can put evidence of a promising programme or approach into sustainable, day-to-day practice. It tries to share ideas on what gets in the way of good practice (the barriers) and what seems to help. It highlights how the different contexts of organisation, policy and funding must be seen as “front and centre” of implementation, as otherwise evidence-based practice from carefully controlled and well-funded research trials are hampered by poor real-world implementation, and innovative, culturally responsive, real-world programmes are never taken to needed scale. (Lambie & Gerrard, 2018, p.47)

Lambie and Gerrard’s review goes onto to describe the factors that require consideration for successful implementation and barriers to implementation and a call for much more national systemic focus in this area.

Evaluations play a critical role in understanding the barriers and enablers to implementation as well as identifying areas for service improvement and outcomes for service users. Affordability of evaluations is often an issue, which makes it difficult for local initiatives to be evaluated. The government, via the prevention campaign, It’s not OK, has previously published Community Action Toolkits which include a self-evaluation guideline for community organisations.⁴⁵ They have also funded evaluation capability building with NGOs. However, it can still be a challenge due to staff capacity to undertake this work.

4.6 Collaborative responses to enhance service system responses

This section provides two recent examples of interagency approaches to improve collaborative responses to reports of family violence.

4.6.1 Integrated Safety Response initiative

The family violence ISR initiative, introduced in Christchurch and Waikato in 2016, sits squarely within the crisis response (or ‘make safe’) category. The ISR initiative was intended to replace the Family Violence Interagency Response Model System, which operated throughout Aotearoa New Zealand in the same crisis response space from 2006.

ISR’s core aims are to ensure the immediate safety of victims and children and that perpetrators are connected with an appropriate service to assist in preventing further violence.

Each day, multi-agency ISR Safety Assessment Meeting (SAM) teams⁴⁶ at each site triage about 40 families and/or whānau referred to it through a Police report of a family violence episode.⁴⁷ (ISR does not take self-referrals.)

ISR grades its response to a particular family and/or whānau according to its assessment of that family’s risk of further family violence. The maximum amount of support a family assessed as ‘high risk’ (3% of all families) receives is about 40 hours of support from a specialist worker (for a victim and/or a perpetrator) for up to 12 weeks. Most families are assessed as either medium risk (51%)⁴⁸ or low risk (46%).⁴⁹

The ISR costs about $5 million per site per year. The fact that ISR funding does not currently extend to the funding of longer-term (‘keep safe’) services is somewhat contentious, especially because about one-third of referrals for a family violence episode are repeat referrals (Mossman, Paulin & Wehipeihana, 2017).

ISR has been evaluated twice. The 2019 evaluation found that families and whānau greatly valued the ISR support they received and found some evidence of improvement in wellbeing as a result of this support. After having received ISR support, families and whānau from whom feedback was obtained reported feeling safer (especially if they were high-risk victims) and better connected to their support networks (such as whānau, hapū, friends, wider family networks and support agencies).

The 2019 evaluation also found some indication of reduced rates of family violence behaviour, with Māori victims having significantly lower rates of repeat reported family violence offending against them in the six months following their ISR referral compared to a matched control group.

Although ISR was assessed as at least ‘good’ on five dimensions of operating as a whānau-centred delivery model, the evaluators also identified the need for improved access for whānau to the support services they needed. They also suggested that ISR and Whānau Ora could be better connected to ensure seamless support for whānau.

4.6.2 Whāngaia Ngā Pā Harakeke initiative

The Whāngaia Ngā Pā Harakeke (WNPH) initiative, developed by the Police in partnership with local iwi and communities, was introduced around the same time as ISR at three other sites – Counties Manukau, Tairāwhiti/Gisborne and Kaitaia – and is being extended to some other sites. WNPH also operates in the crisis response space. It is funded by the Police.

The following table compares the main features of both models.

Table 5: Features of two multi-agency family violence crisis response models compared

From Mossman E., Wehipeihana N. & Bealing M. (2019). Evaluation of the family violence Integrated Safety Response pilot. Phase II – Years 2 & 3. Final Report, page 25.

The most significant features distinguishing ISR from WNPH are:

• the government mandate and ring-fenced funding;
• the provision of a dedicated team overseeing operations;
• the funding of community-based specialist positions to provide intensive short-term safety work and more assertive outreach; and
• the purpose-built electronic management system that supports the tracking of tasks and enables information sharing (Mossman, Wehipeihana & Bealing, 2019).

39: Berghan, G., Came, H., Coupe, N., Doole, C., Fay, J., McCreanor, T., & Simpson, T. (2017). Te Tiriti o Waitangi-based practice in health promotion. https://trc.org.nz/treaty-waitangi-based-practice-health-promotion

40: MartinJenkins, (2019). Social Service System: The funding gap and how to bridge it. Jointly funded by social service providers and jointly funded with philanthropic organisations. See https://www.sspa.org.nz/images/Social_Service_System_-_The_Funding_Gap_and_How_to_Bridge_It_-_FULL_REPORT_FINAL.pdf

41: Ministry of Social Development, (2020). Social Sector Commissioning: Progress, Principles and Next Steps. Wellington. See https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/social-sector-commissioning/msd-social-sector-commissioning.pdf

42: See https://www.careerforce.org.nz/family-violence-sexual-violence/

43: See https://nzfvc.org.nz/education-and-training/training-and-professional-development

44: Thomas, C., Petrangelo Scaia, M., Greenan, L., McGowan, M., & Waligorski, L. (2020). Coercive Controlling Violence with Considerations During COVID-19 webinar. https://www.youtube.com/watch?v=usGitnUGtPM&feature=youtu.be

45: http://www.areyouok.org.nz/resources/free-resources/community-action-toolkit/

46: Statutory agencies represented on the SAM team are Police, the Department of Corrections, Oranga Tamariki, the Ministry of Health and Māori/iwi.

47: In addition, a very small number are referred through a notification from the Department of Corrections about the imminent release from prison of high-risk perpetrators of family violence.

48: Those families assessed as medium risk are visited by a case worker within 72 hours. Family members may be assigned a whānau support worker and/or a specialist worker to support them (as victim or perpetrator) for about five hours over the following six weeks.

49: Those families assessed as low risk receive just over one hour’s support (mostly by phone) from a case worker.