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Building Capacity

Concerted efforts have been made to build the capacity of universal health and education workforces to identify family violence

The government’s self-reported progress for MARAM implementation can be found in each year's Annual Report on the Implementation of the Multi-Agency Risk Assessment and Management Framework.

Family Safety Victoria is the lead agency for the MARAM rollout and has produced an extensive suite of resources including a range of practice guidance and resources to support organisational alignment with MARAM. A summary of these documents is captured in Table 2.

As well as an extensive suite of resources, Family Safety Victoria also provides ongoing support for the agencies implementing MARAM for particular workforces through regular bilateral meetings, a MARAM implementation team available for advice, and a review and support function for all MARAM training that is developed by agencies. Family Safety Victoria has also funded Sector Capacity Building Grants to support MARAM alignment for peak bodies and leading organisations, including one-off funding to three multicultural sector organisations during the COVID-19 pandemic. Governance arrangements for the MARAM rollout include:

  • the MARAM and Workforce Directors Group, which meets quarterly to oversee and provide strategic advice on the implementation of the MARAM Framework, Family Violence Information Sharing Scheme, Industry Plan and the first Rolling Action Plan of the Industry Plan
  • the MARAMIS (MARAM and information sharing) and Workforce Implementation Working Group, which brings together key stakeholders from across the various sectors affected by MARAM and Family Violence Information Sharing Scheme, as well as relevant government representatives.

The 2020 Process Evaluation of the MARAM Reforms noted delays for some parts of the MARAM Framework (for example, the perpetrator guidance and guidance for working with particular cohorts) but was positive about the design of the framework and the usefulness of the practice guides:

Stakeholders reflected an appreciation of the strength of the new risk assessment approach and a recognition of the research and evidence that underpins it. In particular, the Victim Survivor practice guidance represents a comprehensive suite of practice guidance addressing all ten responsibilities defined in the MARAM Framework and provides definitive guidance based on leading evidence and practice.1

The inclusion of [the ten] responsibilities in the MARAM Framework is the first time in Victoria (or any Australian jurisdiction) that responsibilities have been specified for all organisations that intersect with family violence.2

These resources are available publicly for all prescribed organisations to use, and where tailored sector guidance doesn’t (yet) exist, government advice is for organisations to refer to the core MARAM practice guides. However, a common theme across our consultations was that the MARAM guidance was very dense and can be difficult to engage with, even sometimes for specialist services but particularly for smaller services. Implementing agencies (such as the Department of Education and Training and the Department of Health) are responsible for leading development of sector-specific training, guidance and resources that takes into account the various starting points and contextual needs of different workforces (such as the differences illustrated in Table 3 at the end of this section). We have seen substantial evidence of the range of sector-specific guidance that has been or is being developed. Workforces are overwhelmingly calling for practical and easy-to-understand guidance that explains precisely what is expected of them, provides scripts to guide conversations with potential victim survivors, and includes simple information about where to go for advice, referrals and support.

Table 2: MARAM resources available online to universal (and all) services

MARAM Framework
  • MARAM Framework - Framework to establish a system-wide shared understanding of family violence
  • MARAM Framework on a page – one page summary of the MARAM Framework
Practice guide resources and tools
  • Foundation Knowledge Guide – a comprehensive resource for all professionals to support a shared understanding and recognition of family violence
  • Adult and child victim-focused MARAM practice guides (released 2019) – guidance specifically for professionals working with adults and child victims
  • Adult perpetrator-focused MARAM practice guides (released June 2021) – guidance for all non-specialist professionals who may engage with people using violence in their usual service delivery
  • MARAM Practice Guides: Chapter Summaries (victim survivor focused) – a summary of the adult and child victim-focussed MARAM Practice Guides.
  • Frequently asked questions about the MARAM Practice Guides – responses to common questions from practitioners and organisations about the MARAM Practice Guides
  • Coronavirus (COVID-19) pandemic-specific practice guides and resources – guidance to support family violence responses during the COVID-19 pandemic
Organisational focused resources
  • Organisational readiness checklist (people who use violence guidance) – high-level steps to help organisations align to the MARAM perpetrator guidance.
  • MARAM responsibilities decision guide – guidance to assess an organisation’s roles and responsibilities under MARAM
  • Organisational embedding guide
    • Step 1: MARAM organisational self-audit tool – tool to assess current progress of MARAM alignment
    • Step 2: Project implementation plan – Example of how to put priorities identified in Step 1 into an implementation plan
    • Step 3: Implementation review – guide to reviewing the success of implementation activities
  • MARAM Framework summary – A short guide to the core components of the MARAM framework for organisational leaders.
  • MARAM responsibilities guide – A short guide to the 10 MARAM responsibilities with organisational considerations.
  • Embedding tools into existing practice – things to consider when deciding whether to adopt the MARAM tools in full or embed into existing tools
  • External partnerships – guidance for effective coordination between services
  • Supporting staff: family violence leave policy considerations
    • Workplace safety plan – guidance for organisations around family violence leave policies, support for managers and workforce safety plans
  • Executive briefing slides – prepared slides and speaking notes explaining the MARAM to organisational leaders.
  • MARAM Responsibilities Mapping Tool – template for mapping of roles and determining MARAM responsibilities
  • MARAM alignment checklistChecklist guide for organisational leaders to start aligning their organisational policies, procedures, practice guidance and tools to MARAM

Source: Family Violence Reform Implementation Monitor, based on information from the MARAM practice guides and resources webpage

Hospitals

The Strengthening Hospital Responses to Family Violence (SHRFV) initiative began in 2014 as a whole-of-hospital model for responding to family violence among patients. Additional Victorian Government investment from 2016–17, provided in response to Recommendation 95 from the Royal Commission, enabled the initiative to be rolled out across the state. The model was developed by the Royal Women’s Hospital and Bendigo Health, and these two hospitals remain the sector lead hospitals for the initiative, with 27 additional hospitals funded to provide mentoring and support to the remaining services. Under the model, every hospital employee is expected to have an understanding of family violence, be trained in accordance with their position and scope of practice, and to have a role in identifying family violence.

The initiative includes training, a toolkit of customisable resources and a collaborative network for discussion and sharing of best practice. The fifth edition of the SHRFV toolkit includes alignment with MARAM and the information sharing schemes. Stakeholders spoke positively of the initiative and said it set a solid foundation for the introduction of MARAM. This is confirmed by the substantial progress in MARAM and information sharing implementation by the July to September 2021 quarter, as shown in Figure 3, despite hospitals only being prescribed in April 2021 and despite the significant pressure the hospital system has been under as a result of the COVID-19 pandemic.

Figure 3: Self-reported level of implementation of MARAM and information sharing reforms in Victorian hospitals and health services

Source: Bendigo Health and Royal Women’s Hospital, Strengthening Hospital Responses to Family Violence (SHRFV) Program State-wide Quarterly Report: 1 July 2021 – 30 September 2021

  • Download' Figure 3: Self-reported level of implementation of MARAM and information sharing reforms in Victorian hospitals and health services'

Results of the System Audit Family Violence Evaluation (SAFE) Project, which was conducted in selected hospitals and health services at three points in time across 2019 and 2021, suggest that ‘while the health services have systems in place to respond to family violence, there continues to be a need for further resourcing and improvement in a range of domains at all participating sites’.3 The audit resulted in each participating hospital achieving a score across a series of domains. High scores were achieved for foundational measures (such as having policies, procedures and guidelines in place); however, the ‘identification and response’ domain was one of the lower scoring domains (see Figure 4), indicating that more needs to be done to support hospitals to embed family violence policies in practice.

Figure 4: Statewide median score for each SAFE audit domain, from lowest to highest scores

Source: The Royal Women’s Hospital and the University of Melbourne (2021). The System Audit Family Violence Evaluation (SAFE) Project, Final Report, p. 5.

  • Download' Figure 4: Statewide median score for each SAFE audit domain, from lowest to highest scores'

General practitioners

GPs are not prescribed under the MARAM Framework (only the information sharing schemes), but they play an important role in identifying and responding to family violence. Approximately 83 per cent of Australians see a GP at least once a year, and victim survivors are more likely to disclose to GPs over any other group, except family and friends.

The government had previously been criticised for a lack of ‘sufficient engagement with this sector’. However, in the past two years, considerable progress has been made. The University of Melbourne’s Safer Families Centre – which is leading a national, Australian Government–funded family violence training program for primary health care providers, The Readiness Program – has received funding from the Victorian Government to create a Victoria-specific, MARAM and information sharing–aligned version of the program. The Safer Families Centre convenes a MARAM and Information Sharing Advisory Group to guide this work, with representation from Family Safety Victoria, the Department of Health and the Royal Australian College of General Practitioners. Key components of the work include:

  • a Victorian supplement covering MARAM and the information sharing schemes to the latest edition of the Royal Australian College of General Practitioners’ ‘White Book’ (officially titled Abuse and Violence: Working with our Patients in General Practice, 5th edition)
  • development of a Victoria-focused information sharing e-learning module
  • management and delivery of a virtual practice-centred intensive learning program at 22 sites.

Maternal and child health

Prescribed in phase 1 of the MARAM rollout, the maternal and child health workforce (of approximately 1,500 staff) has previously engaged in family violence training, but more recently, 1,406 maternal and child health nurses completed tailored MARAM Screening and Identification training delivered by the Centre for Excellence in Child and Family Welfare. The training focused on supporting nurses to confidently identify and respond to family violence risk and collaborate with specialist services. In addition to this, we understand a MARAM Screening and Identification eLearn package has been developed by the Department of Health for health workforces, including maternal and child health staff.

The Department of Health funds an additional maternal and child health 60-minute consultation for cases where families are experiencing or are at risk of experiencing family violence. Maternal and child health nurses are supported by a practice note that guides nurses through the consultation, including specific family violence risk assessment questions. The Department of Health was not able to provide data on the use and outcomes of these consultations.

Further resources are available through the Municipal Association of Victoria, which was funded to develop a suite of tailored practice guidance and resources for the maternal and child health workforce.

Data on the effectiveness of the maternal and child health workforce in identifying and responding to family violence is not currently available but is expected through an evaluation due to be finalised in late 2022.

Schools

The Department of Education and Training led a two-year trial across 2018 and 2019: Supporting Student Cohorts Affected by Family Violence Initiative (Family Violence Initiative). The initiative’s evaluation suggests it was highly effective, and in 2021 it received the Evidence Based Policy Award at the IPAA Leadership in the Public Sector 2020 Awards for achieving ‘significant increases in school staff members’ levels of awareness, knowledge, skill and confidence to support students affected by family violence as well as increased identification and improved referral pathways’.4 Participating schools received training and materials, clear roles and responsibilities were defined for everyone within the school and broader community, and schools and partner organisations participated in Local Area Working Group meetings.5

According to the Department of Education and Training, this initiative aimed to create a best practice process for schools to respond to family violence, noting that the whole-of-government victim survivor MARAM practice guidance had not been released and education was not yet prescribed. Anecdotally, participating schools experienced a spike in family violence identification numbers, suggesting there may be significant unmet need in schools.

Specialist roles at the regional level, and one or two staff per school, are expected to have targeted MARAM training developed for them over time to enable them to support schools as part of a differentiated workforce approach. However, the main way MARAM is currently being implemented for school-based staff is through the following measures:

  • The delivery of information sharing and family violence reforms interactive webinars and eLearns. These primarily focus on information sharing obligations, and provide a brief introduction to MARAM. Schools are advised that one leader and two staff members per school should complete sessions in person or online, although more staff can be trained if desired.
  • The Information Sharing and Family Violence Reforms Toolkit and Contextualised Guidance, which were developed in close consultation with education and care professionals, was designed to help organisations prepare their workplaces for implementation and provide guidance on information sharing.
  • The revision of Respectful Relationships ‘responding to disclosures’ training package to align with MARAM and information sharing reforms, being undertaken in partnership with Safe and Equal. The Respectful Relationships whole-school approach (which has been adopted by almost 2,000 Victorian government, Catholic and independent schools) includes access to on-the-ground support from Respectful Relationships area staff, who are expected to have a major role in implementing MARAM in schools. This training might more suitably be named ‘identifying and responding to family violence’ training because this would better reflect the content of the training and would emphasise the active role of staff in identifying family violence.
  • Content provided as part of PROTECT guidance. The guidance includes advice for schools and others about their obligations under the Child Safe Standards, Mandatory Reporting and Duty of Care and how to identify and respond to all forms of child abuse, including family violence. Staff are also required to complete Mandatory Reporting training, which covers responses to disclosures and suspicions of child abuse.

The Department of Education and Training has advised that it is drawing on key learnings from the Family Violence Initiative to inform its approach to MARAM alignment; however, there are some clear divergences from the trial in the department’s approach to MARAM implementation in schools, such as the train-the-trainer approach for Respectful Relationships disclosures training. Under this approach, Safe and Equal trains Respectful Relationships area staff, who then deliver the training to schools signed on to Respectful Relationships. However, we understand that schools’ willingness to welcome this training into the school varies and, while all school staff are invited to participate, it is not clear what proportion of staff normally attend. We also understand that the training will only be repeated or ‘topped up’ if a school requests this of area staff, yet the president of the Victorian Principals’ Association emphasised the importance of ongoing training in this area. It is also less explicit that this is a whole-of-school approach to identifying and responding to family violence, even though this is a key feature of the Respectful Relationships model and of the SHRFV model for hospitals.

Consultations with school sector representatives suggest there is still considerable progress to be made to ensure all schools know what the MARAM Framework is and to gain a clear understanding of their obligations [relates to action 11]. It will be vital to measure the impact of the approach to MARAM implementation over time, not just from the perspective of principals but also classroom teachers, wellbeing staff, administrative and other support staff, who all have a role in identifying and responding to family violence [relates to action 13]. The planned and funded evaluation of MARAM implementation in education settings will be an excellent first step in measuring effectiveness.

Early childhood education and care

The early childhood education and care sector has access to much of the same training and resources as schools. For example:

  • This sector also has access to similar PROTECT guidance. Some early childhood educators working in Victorian government-funded kindergarten programs with a bachelor, diploma or certificate III qualification can access Respectful Relationships education that has been tailored for this workforce by Monash University.
  • Information sharing and family violence reforms eLearning, and the Information Sharing and Family Violence Reforms Toolkit and Contextualised Guidance, are also available to this sector.

While it would have been prudent to have tailored training and resources available when organisations were prescribed in April 2021, this work is now underway through the Building Family Violence Prevention and Response Workforce Capability Project, which brings together the Department of Education and Training, Early Childhood Australia and Family Safety Victoria. Consultation with the sector has occurred, and tailored resources are being developed and will be shared with the three pilot organisations from May 2022 [relates to action 11]. The consultation report made a series of recommendations, including the need for regular communication about family violence reforms, sector-specific resources, more MARAM-related content in the available webinars and eLearns, and better promotion of the MARAM and information sharing enquiry line. Early Childhood Australia advised that through this project it will develop resources such as:

  • a more streamlined family violence screening tool
  • a secondary consultations flowchart for its staffroom
  • a fact sheet for centre directors to use at induction with new staff.

Concurrently, the Department of Education and Training has worked with Monash University to develop and deliver training for early childhood educators on identifying family violence and responses to family violence disclosures.

Table 3: Selected ‘broader workforce’ results from the 2019–20 Census of Workforces that Intersect with Family Violence

Community health Early childhood Maternal &
child health
Public health
services
Schools
# of respondents 328 136 135 565 82
Proportion who:
are in contact with
individuals who
are experiencing
or at risk of family
violence, at least
weekly
37% 28% 42% 24% 47%
are in contact with
individuals who
are perpetrating
or at risk of
perpetrating
family violence,
at least weekly
23% 9% 12% 15% 20%
are very or
extremely
confident
identifying family
violence among...
  • 38% adults
  • 38% CYP (Children and Young People)
  • 26% perpetrators
  • 9% adults
  • 40% CYP
  • 13% perpetrators
  • 33% adults
  • 35% CYP
  • 17% perpetrators
21% adults
22% CYP
15% perpetrators
  • 28% adults
  • 42% CYP
  • 18% perpetrators
are confident that
they have had
enough training
and experience in
relation to family
violence response
to perform their
role effectively
34% 11% 33% 18% 25%
want more
training in
(top 3 areas)
  • 57% MARAM
  • 46% FV legal issues
  • 51% Working with perpetrators
  • 62% CRAF/working with children exposed to FV
  • 57% MARAM
  • 54% FV identifying and screening
  • 61% FV legal issues
  • 53% MARAM
  • 49% Working with perpetrators and migrant/ refugee communities
  • 60% MARAM
  • 51% FV legal issues
  • 51% FV safety planning
  • 50% MARAM
  • 60% working with children exposed to FV
  • 50% CRAF/ FV identifying and screening/ working with perpetrators and migrant/ refugee communities

Source: Family Safety Victoria.

Note: FV = family violence; CRAF = Common Risk Assessment Framework (the precursor to MARAM)

Endnotes

  1. Cube Group (2020): Family Safety Victoria: Process Evaluation of the MARAM Reforms Final Report (unpublished).
  2. Ibid.
  3. The Royal Women’s Hospital and the University of Melbourne (2021): The System Audit Family Violence Evaluation (SAFE) Project, Final Report, p. 4.
  4. State of Victoria (2021): Annual Report on the Implementation of the Multi-Agency Risk Assessment and Management Framework 2020–21, p. 14.
  5. Acil Allen Consulting (2020): Report to Department of Education and Training: Supporting students cohorts affected by family violence initiative, Final Report (unpublished).

Updated