“Unethical In The Extreme”: Trauma Counselling Service Splits With 1800RESPECT Hotline
Rape & Domestic Violence Services Australia have raised serious concerns.
The long-running provider of trauma counsellors for the sexual assault and domestic violence hotline 1800RESPECT has parted ways with the service over serious concerns with a new operating model, which it says undermines callers’ trust and expectations of confidentiality.
1800RESPECT was launched in 2010 to provide 24/7 telephone counselling and support for people experiencing sexual assault or domestic and family violence. It’s run by Medibank Health Solutions (MHS), a privately owned organisation, on behalf of the Federal Government, and has historically subcontracted Rape & Domestic Violence Services Australia (RDVSA) to provide specialist trauma counselling.
RDVSA announced yesterday that it would not be accepting a new subcontract offered by MHS on August 10, due to concerns that new requirements to record all calls and share these, along with existing case files, with MHS raises privacy concerns for callers. Following the expiry of its current subcontract in October, it will no longer work with 1800RESPECT.
Karen Willis, Executive Officer of RDVSA, told Junkee that the organisation is incredibly sad to leave 1800RESPECT, but felt it would be “unethical in the extreme” to remain. While RDVSA has raised a number of concerns with MHS, Willis said the main dealbreakers were the new requirements to record calls and share case notes with MHS.
“It’s very difficult for someone to contact a service to talk about the violence they’ve experienced, so when someone does take that step they’re entrusting us with a lot. The thought that we’d disrespect that by handing their files over to a large multinational private company that could be sold tomorrow — I’m pretty sure that most people who called us wouldn’t be happy with that,” she said.
In a press release announcing its decision to leave, RDVSA also raised a number of other concerns with the new model, including that the new contract required the organisation to agree to follow counselling models and training they had not yet seen.
RDVSA also argued that 1800RESPECT’s planned transition to a “triage” system where MHS staff field initial calls and refer them to one of four other organisations “presents a considerable risk that 1800RESPECT will become an information and referral service which will no longer seek to provide high quality evidence based client centered trauma counselling to those who have a right to expect nothing less”.
Medibank’s Chief Medical Officer, Dr. Linda Swan, said the new system’s aim is to “provide a world-class national sexual assault, domestic and family violence counselling service” that is “consistent, responsive and accessible for women 24 hours a day 365 days of the year”. She said MHS respected RDVSA’s decision to leave, but did not comment on the specific concerns raised by the organisation.
In a press release responding to RDVSA’s announcement, Minister for Social Services Christian Porter said the changes to 1800RESPECT were aimed at improving the service’s ability to meet caller demand and reduce wait times.
He expressed confidence that the service would remain high-quality “with three highly capable specialist trauma providers from across Australia, being DV Connect in Queensland; SafeSteps in Victoria; Women’s Safety Services in South Australia” signed on to provide services under the new system.
Like “Auditioning” To Get Access To Trauma Counselling
Advocates for survivors of sexual assault told Junkee a number of the concerns raised with 1800RESPECT are not new, and speak to problems that have been occurring since changes were made to the service in August 2016.
These changes were in response to an independent review of 1800RESPECT, which was commissioned by the government to address the service’s long wait times and high number of unanswered calls. The changes saw 1800RESPECT switch to a triage system, where calls were first answered by MHS staff, and only referred to RDVSA trauma counsellors if a caller was determined to require specialist trauma counselling.
Karen Willis from RDVSA agreed that demand for the service had outstripped the organisation’s capacity to respond at the time of the review, and that changes needed to be made, but disagreed that MHS’s triage system was an effective solution, pointing instead to a need for more government funding directly to trauma counselling services like RDVSA.
We are sad to inform our supporters that we have decided to withdraw from the 1800RESPECT service – https://t.co/hDdMGK0xDs
— R&DVSA (@rape_dvservices) August 30, 2017
She told Junkee RDVSA had received multiple complaints from callers who felt they now had to “audition” to access trauma counsellors they had previously had immediate access to.
Sharna Bremner, Director of End Rape On Campus Australia said that her organisation no longer refers people to 1800RESPECT for this reason.
“Too many of the survivors we have worked with have reported unprofessional and inappropriate responses, which in at least one case placed their life at risk,” she told Junkee.
“Over and over survivors have reported to us that they had terrible interactions. In one case an MHS phone operator admitted she hadn’t even looked at her own website. In another call, a client was advised that drinking alcohol could take the edge off.”
MHS maintains that its first responders are qualified counsellors with a three year degree in an equivalent field.
This breaks my heart. 1800RESPECT is basic women's health & safety. It should have never been privatised #noprofitfromrape https://t.co/U2FQtPrcDs
— Nele Vandersmissen (@HalloNeleHallo) August 30, 2017
Willis said that in seeking to address wait times above all else, MHS had lost sight of “what happens after you pick up the phone”.
“What has now become the measure of quality is picking up 80% of calls within 60 seconds,” she said. “That’s a great metric — that’s what we should be aiming for. But what’s happening is that that’s the measure, end of story. What you do when you pick up the call is also important.”
“The next step is to provide a high quality service, that’s targeted to the client’s needs, that has counsellors with the trauma experience, and supports the caller to take their next steps. That takes a while sometimes, but if someone’s experienced shocking violence, we have an obligation to actually take that time to sit with them and listen to what needs to be done.”
Willis says this trauma counselling expertise is what RDVSA brought to the table, and that while “people who ring 1800RESPECT will still get caring, compassionate people, they’ll now be working within an MHS model that is not best practice”.
“The last thing we want to do is discourage people from contacting, because they will still get a service, but it won’t be as good as what we could have done.”
An Uncertain Future Looms For Rape & Domestic Violence Services Australia
Following their exit from 1800RESPECT, the future of RDVSA is now uncertain. While the organisation will still provide counsellors through a number of services including NSW Rape Crisis Centre, it is struggling to find funds to pay redundancies for 70 staff who will be let go in October.
Willis says that even if RDVSA had remained with 1800RESPECT, it still would have had to lay off 50 staff due to funding being split between the group of organisations invited to join the triage service under the new system.
Redundancy payments will cost the organisation “nearly a million dollars” according to Willis, who is seeking support from the government to make the payments. She expressed regret that the organisation had to lay off so many experienced trauma counsellors, “especially just before Christmas”.
“These are women who’ve done nothing but the best, and deserve the best,” she said.