Responding to family violence in Aboriginal communities: The NSW Aboriginal Family Health Strategy

Family violence has a devastating impact on the health and wellbeing of Aboriginal communities.¹ In 2008, there were six times more Aboriginal than non-Aboriginal women reported to be victims of domestic violence (NSW Health data request on number of Indigenous victims of domestic violence related assault recorded by the NSW Police, NSW Recorded Crime Statistics from July 2006 to June 2009, from NSW Bureau of Crime Statistics and Research). The number of child protection reports made to the NSW Department of Community Services for Aboriginal children and young people has increased by more than three fold in the past 8 years.²

The Aboriginal Family Health Strategy,³ first released in 1998 presented an innovative approach to working to address family violence within a cultural context. The Strategy was originally limited to the individual and family support activities of Aboriginal Family Health Workers, including initial crisis support, advocacy and referral. Reviews of the Strategy identified a number of challenges including: the complexity of family violence; workforce shortages; community expectations; lack of consistent and coordinated service delivery; and the risk of duplicated effort due to the numerous interagency and whole of Government strategies targeting some locations.

A revised Aboriginal Family Health Strategy, released on National Sorry Day 2011, is being integrated into the NSW Health system as a model of care (Figure 1).⁴ The focus is family and culture with four elements: effective service delivery, strong community capacity, culturally competent work force and strategic leadership. It is built on a healing approach and is informed by research and evidence. The application of this model into mainstream services provides practical ways to enhance efforts within a culturally competent framework.

Figure 1.  Aboriginal Family Health model of care
Source: Aboriginal Family Health Strategy

Effective service delivery: Currently 25 Aboriginal Family Health Workers are employed in prioritised areas of need, predominantly in Aboriginal Community Controlled Health Services (ACCHS) in regional NSW, and one position in the Justice Health system.

Strong community capacity: Locating Aboriginal Family Health Workers in ACCHS is in keeping with the philosophy of the strategy that ‘solutions to family violence in Aboriginal communities will be community devised, managed and implemented’. These workers are now focusing more on early intervention and education which, when combined with a healing process, aims to build strong and resilient communities.

Culturally competent workforce: The Education Centre Against Violence supports the work of the Strategy to enhance the capacity of the Aboriginal workforce, and addresses recruitment and retention issues. The Certificate IV in Aboriginal Family Health and the NSW Advanced Diploma of Aboriginal Specialist Trauma Counselling ensure Aboriginal workers are equipped to address the complex needs of Aboriginal families. The Centre also provides training to develop the cultural competency of the non-Aboriginal workforce.

Strategic leadership: A trial of Aboriginal Family Health Coordinators, located in four Local Health Districts, is being undertaken. These coordinators will undertake a strategic role to facilitate better access for Aboriginal families to services responding to issues of family violence, including child protection.

Monitoring and evaluation: Information from the Aboriginal Family Health Worker Data Collection and preliminary evaluation of the Aboriginal Family Health Coordinator trial highlight the diverse needs of communities and the difficulty of evaluating a program based on a holistic approach that emphasises healing. Formal evaluation of the Aboriginal Family Health Strategy is planned to commence in 2012. In the long term, the success of this Strategy will be assessed from a family and community-based perspective, in accordance with the principles of Aboriginal health.