Consultations revealed a shared understanding of the importance of mainstream health and education services being able to identify the signs of family violence and appropriately acknowledge and respond to disclosures. Victim survivors were unanimous in wanting these services to be able to sensitively ask questions about possible family violence, explaining that even if a victim survivor is not ready to disclose, these questions can help them realise that they are experiencing family violence, and that help might be available.
Considerable work has been undertaken and funding provided to equip staff in universal health and education services to identify and respond to family violence, and MARAM is a commendable approach to ensuring multiple workforces across numerous sectors have a shared understanding of family violence, with a clear role to play in responding to it. Our consultations revealed that while Family Safety Victoria’s MARAM materials are high-quality, workforces rely on the tailored guidance developed for their sector, where it exists, and have a strong desire for simple and practical guidance. This tailored guidance for each workforce is at various points of development.
Acknowledging that embedding MARAM in organisational practice involves long-term capability building and cultural change, and that a degree of practice inconsistency may be expected but should reduce over time, multiple themes emerged from our consultations with service providers, peak and professional associations, government departments and academics.
These themes form the following section headings in this report:
- Concerted efforts have been made to build the capacity of universal health and education workforces to identify family violence.
- There are areas of planning and modelling that could be strengthened.
- There is recognition that staff identifying family violence, particularly those with lived experience, need dedicated support from their workplace.
- A number of implementation challenges were raised that will need to be considered in the ongoing implementation effort.
- Certain cohorts face additional barriers to having family violence identified by universal services.
- There is variability in access to services after family violence has been identified.
- A clear model for secondary consultations would improve coordination and consistency.
- Ongoing monitoring of reform progress and impact is essential.
There is a considerable amount of activity already underway to implement and embed MARAM in universal services, and to coordinate services and systems to better support victim survivors. We propose consideration of the following 13 actions (Figure 1) to strengthen future activity and better support family violence identification within universal services. Most of these actions relate to areas of MARAM implementation that are underway and are our suggestions of where additional focus or effort is required within this work, particularly to ensure consistency across prescribed organisations.
While these proposed actions are presented in separate categories, they are interconnected and cannot be undertaken effectively in isolation. They require Family Safety Victoria, responsible departments and sector representatives to come together to carefully plan how the system will operate. This includes longer term consideration of what training and tailored guidance workforces need, and how secondary consultations and referrals should work.
Figure 1: Thirteen proposed actions to support family violence identification within universal services
- Allocate implementation support funding for multiple years and ensure further funding is communicated well in advance of its expiry so staff are not lost.
- Victoria advocate with the Commonwealth for the creation of Medicare items relating to family violence to support General Practitioner’s identification and management of family violence as envisioned in the National Plan.
Referrals and Secondary Consultations
- Develop high-level models for referrals and secondary consultations with input from the specialist sector, universal services sectors and family violence regional integration committees.
- Provide sector-specific advice to staff in universal services on referral and secondary consultation options with input from the specialist sector, universal services sectors, Aboriginal Community Controlled Organisations and family violence regional integration committees.
- Analyse the source, frequency and length of secondary consultations, and how they are being managed and delivered by the specialist sector, including The Orange Door network.
- Ensure that prescribed organisations have appropriate trauma-informed policies and support for staff with lived experience; and track the effectiveness of existing employee wellbeing measures.
- Generate more detailed sector-specific guidance around what providing ongoing support for victim survivors within their services should look like after family violence has been disclosed, and look for opportunities to co-design this advice with victim survivors.
- Update guidance around school transitions to ensure that information pertaining to family violence risk is consistently communicated, particularly the major transitions from early childhood settings to primary school, and primary to secondary school.
- Re-examine existing and required training for all prescribed workforces and use this to inform longer term planning for workforce training.
- Further consider what is required to embed MARAM capability among prescribed workforces including through:
- additional strategies to incentivise phase 2 workforces to engage in training, build their family violence capability and see the inherent value in doing so
- access for every prescribed organisation to some form of dedicated support for their organisational alignment with MARAM.
- In progressing with training and communication approaches for education workforces, ensure these build an awareness of what the MARAM Framework is and what it means for staff , and clearly articulate how it intersects with and differs from existing initiatives and systems.
Tracking MARAM Implementation Progress
- Actively seek frontline workforce feedback about MARAM implementation to feed into governance groups and bilateral meetings.
- Support and encourage impact-focussed data collection from a range of sources, and regularly bring together quantitative data to form a coherent and meaningful view of MARAM implementation across the system.
Reviewed 10 May 2022