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Dr Ruth Gammon believes we could learn a lot from the ‘wraparound’ system of care developed in the United States.
By Dr Ruth Gammon.
New Zealand presents itself to the world as pristine and beautiful – 100% Pure, with snow-covered mountains, crystal clear rivers and dolphins playing joyfully in our oceans. But behind the billboards is another reality: our people suffer one of the highest rates of family violence in the world.
New Zealand has the fifth worst child abuse record out of 31 OECD countries. On average, one child is killed every five weeks. Most are under five and 90 per cent are killed by someone they know. Studies have estimated one in four girls aged under 15 have been touched sexually or made to do something sexually they did not want to.
At least one in eight boys have experienced sexual abuse (although the rates are likely to be much higher, as sexual abuse among boys is still under reported). Of real concern is the rate for Māori girls – twice the rate of European or other ethnicities. Currently, over 5000 children are in the care of the Ministry of Social Development, with over 4000 children living in ‘out of home’ placements. Both these statistics increased by 6 per cent in the last fiscal year.
The statistics for intimate partner violence are grim too. New Zealand continues to rate among the worst countries for this, with one in three New Zealand women reporting having experienced physical and/or sexual intimate partner violence. When psychological/emotional abuse is included, it jumps to over half. Stories regarding women being murdered by their partner or ex-partner continue to grab headlines too frequently. Approximately half of all homicides and more than half of all reported violent crime in New Zealand is the result of family violence.
Often intimate partner violence is seen as a problem of lower socio-economic groups, or the result of poor education, but the statistics do not support this. A recent study found 26 per cent of women living in homes with a household income over $100,000 a year, and one in four women who have a university degree or higher education had experienced physical or sexual violence from an intimate partner. Despite the relentless pain, suffering and long-term trauma these statistics represent, family violence is treatable and preventable. But appropriate resources and funding are needed.
In recent press releases announcing the new ministry Oranga Tamariki (which I prefer to use as it is a more appropriate name than Ministry of Vunerable Children) calls for a more comprehensive, coordinated approach. But do they have the models needed to make this happen? New Zealand does not yet have a ‘system of care’ – a comprehensive spectrum of multi-dimensional services that are organised into a coordinated network to meet the multiple and changing needs of children and families.
A system of care could address the gaps in services in New Zealand because it is based on core values, rather than a defined programme. The core values for such a system are: child-centered and family-focused; responsive to the needs of the child and family; community-based, and culturally sensitive. But it will take more than simply giving Child, Youth and Family another face lift.
Services need be comprehensive and integrated. They need to be equipped to address the physical, emotional, social and educational needs of the child and family. They must involve families and whānau in all aspects of planning and delivery, have effective case management, and early identification and intervention. Then there must also be a smooth transition to the adult service system as children reach maturity, with protection for the rights of children and families and effective advocacy.
There is also much to learn from the US-based National Wraparound Initiative’s evidenced-based model of Wrapraound that has shown proven results. Contrary to local interpretations, Wraparound is not a package of services to be “wrapped around” families, nor is it a funding stream. Wraparound is a philosophical approach to holistic care planning. It has specific guiding principles, a model of delivery and a theory of change – and it is the combination of these factors that makes it effective. It’s not the services per se, but the process. These approaches and services in other countries have demonstrated a significant reduction in family violence and improved outcomes for youth. But such programmes must adhere to the fidelity of the model to be effective.
Unfortunately there are few programmes in this country following this evidenced-based model, but Massey University research on Wraparound in New Zealand has demonstrated effective outcomes. This includes interviews with people who believe their families may not have survived without such services. We are currently working with the Ministry of Education and other NGOs on training, programme development and evaluation to insure their Wrapround services are adhering to the National Wraparound Initiative’s model.
Cost is always a concern and such programmes are expensive because they are time intensive. Case managers often work with families several times a week to stabilise and ensure safety initially. ‘Measuring the Economic Costs of Child Abuse and Intimate Partner Violence to New Zealand’, by Sherilee Kahui and Suzanne Snively, estimates the economic cost as between $4.1 to $7 billion per year and rising. If nothing is done, the cumulative cost over the next ten years may approach $80 billion. Family violence and child abuse will grow unless we address it. We can pay now, or pay later.
Dr Ruth Gammon is a senior lecturer and the director of the Wellington Psychology Clinic at the School of Psychology at Massey University. She leads research in the area of Wrapround in New Zealand.
Created: 09/12/2016 | Last updated: 09/12/2016
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