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1800RESPECT service

Improvements to the 1800RESPECT service

1800RESPECT provides a confidential and professional counselling and support service available 24 hours a day, 7 days a week.

The service is available to individuals who have experienced or are at risk of domestic and family violence and/or sexual assault, their family and friends, as well as frontline workers.

Background

Established in 2010, 1800RESPECT provides a critical service and aims to ensure that anyone impacted by domestic and family violence and sexual assault can access counselling, information and support when they need it.

This national service is delivered by Medibank Health Solutions (MHS) on behalf of the Australian Government, as part of the National Plan to Reduce Violence against Women and their Children 2010-2022.

As awareness of domestic and family violence has risen, so too has the demand for support. In 2015-16, the average wait time for a call to be answered was over 10 minutes. Some wait times reached up to four hours. Approximately 44 per cent of calls were abandoned.

In response to the service issues, the Australian Government increased funding for 1800RESPECT. In May 2015, the Government invested an additional $4 million to increase the number of trauma specialist counsellors available to assist callers. However, there was only a small improvement in the number of calls answered and it was clear that more needed to be done to provide a satisfactory and sustainable service.

Making a change

In 2015, the Australian Government commissioned an independent review of 1800RESPECT to identify ways to improve the service.

KPMG explored options to reduce unacceptable call wait times and call abandonment rates.

The review suggested a triage approach as the most appropriate operational model to meet the needs of callers and improve the capacity of 1800RESPECT to answer calls quickly – without compromising the service.

This approach is consistent with many other crisis hotlines and health services.

New model

The first response triage model was introduced to 1800RESPECT to ensure that people affected by domestic and family violence and sexual assault are able to access support when they need it.

The new model commenced on 16 August 2016. Under this model, all calls are answered by professional and experienced trauma-informed counsellors with a minimum three-year tertiary degree, and at least two years full-time counselling experience. MHS provides these counsellors with specialist training in trauma-informed counselling focusing on domestic and family violence and sexual assault.

If the caller asks for, or the first response counsellor identifies a need for specialist trauma counselling, the caller receives a warm referral to a trauma-specialist counsellor. This means the counsellor provides the background to the trauma-specialist counsellor, with the caller still on the line, so the caller doesn’t have to re-tell their story.

Not all callers require specialist trauma counselling. The data shows that some need emergency accommodation or referrals to other services, others may be concerned family or friends seeking advice and information, and some are professionals seeking information on how to support a client. Data from the new model shows that approximately 25% of callers require more intensive trauma specialist support.

The clinical processes and procedures for the first response triage model were developed by MHS in consultation with the Implementation Clinical Advisory Group and Rape and Domestic Violence Services Australia (the organisation subcontracted by MHS to deliver the trauma specialist counselling component of the service).

Under the new triage model, callers are quickly able to get the level of support they need, when they need it. Specialist trauma counsellors no longer need to answer all calls – they can now focus on assisting those who require this more intensive level of support.

Successes

This new model has already seen significant improvements to the service level since it was introduced. For example:

  • Since the model’s introduction, almost 80% of calls are answered within 20 seconds.
  • The average call wait time is now 45 seconds, compared to an average call wait time of 10.3 minutes in 2015-16, with some wait times reaching up to four hours.
  • The average call abandonment rate has reduced to just 6.6%, since the implementation of the new model, compared to 44% in 2015-16.
  • The percentage of calls answered between October to December 2016 (following introduction of the new model) was 92% (18,024 calls received, and 16,499 answered) compared to the same period in 2015, where only 17% were answered (17,585 calls received and 2,969 calls answered).

This means people can contact 1800RESPECT with confidence, knowing their call will be answered and they will be able to access trauma specialist counselling if needed. Most importantly, those affected by sexual, domestic and family violence are getting the type of support they need, when they need it.

Media centre

Access the latest media about 1800RESPECT:

Access the latest statistics on violence against women.

Access guides for journalists reporting on domestic violence or sexual assault developed by Our Watch.

More information about 1800RESPECT can be found on its website: 1800RESPECT.org.au

If you are covering a story regarding violence against women and children, please include the following tagline:

If you or someone you know is in immediate danger, call 000. For sexual assault, domestic and family violence counselling services call 1800RESPECT on 1800 737 732 or visit www.1800RESPECT.org.au

Questions and Answers

Has Medibank Health Solutions (MHS) taken over from Rape & Domestic Violence Services (R&DVSA)?

No. MHS has been running 1800RESPECT since it began in 2010. R&DVSA is currently subcontracted by MHS to provide the trauma counselling component of the service.

Why did you change the service?

More had to be done to meet the increasing demand on the service, and make improvements. Call wait times and abandonment rates were unacceptably high, despite the government providing extra funding. The first response triage model is backed by an independent review, and the clinical processes were developed by MHS in consultation with the Implementation Clinical Advisory Group and R&DVSA. Improvements mean people can access the support they need, when they need it. See successes for more detail on how the new model is going.

Does this mean less trauma counsellors?

No. Trauma specialist counsellors are still available to help those who need more intensive support. The new model allows the trauma specialist counsellors to focus on answering calls from those people that need the more intensive support.

Why didn’t you give Rape & Domestic Violence Services Australia (R&DVSA) more funding to increase staff?

We did. In May 2015, an extra $3.6 million was provided to R&DVSA. This funding increased the trauma specialist counsellor staff lby 50 per cent. However, even after the full increase in staff numbers call wait times and abandonment rates remained unacceptably high, with 32 per cent of calls still not being answered and a maximum call wait time of 88 minutes being recorded.

Given the lack of improvement, the Government realised that a fundamental change was required to the operational model for 1800RESPECT to enable it to better cope with the increasing demand and to ensure people received a responsive and supportive service when they called.

What’s the difference in qualifications between triage counsellors and trauma counsellors?

MHS employs qualified, professional and experienced counsellors with at least a three-year tertiary degree in a relevant field, and two years of full-time industry experience. They also receive training in trauma-informed support and domestic and family violence and sexual assault. They’re trained to recognise the signs and dynamics of trauma, enabling them to identify callers who need specialist counselling.

Trauma specialist counsellors also have a three-year tertiary degree or equivalent in a relevant field, and at least three years of industry experience. The current subcontractor, R&DVSA, provides in-house trauma specialist training to its counsellors.

Do women have to re-tell their story under the new model?

No, and they’re not put on hold either. The first responder – a qualified, professional and experienced counsellor – makes a rapid risk assessment of the caller’s needs. If the caller needs or asks for in-depth trauma specialist counselling, they get a three-way ‘warm transfer’ to a trauma specialist counsellor. This means the first counsellor stays on the line and provides information to the trauma-specialist counsellor, so the caller doesn’t have to repeat their story. MHS and R&DVSA worked together to develop the transfer process. Warm referrals are the preferred option, and are considered best practice.

It is worth noting that only around one quarter of all callers need intensive support. Most requests for help are met by the first responders. Other callers need emergency accommodation, are concerned family or friends seeking information, or professionals who’d like advice on how to support a client.

Have complaints increased since the service changed?

Media reports about a spike in complaints aren’t true. Data from October to December 2016 shows MHS received 32 complaints for the quarter. After assessment, only six were substantiated. During this time, MHS handled almost 19,000 contacts – so complaints represented only 0.17% of calls during this time.

Is Medibank Health Solutions making a profit based on calls taken?

No – this is incorrect. Counsellors aren’t paid based on the number of calls they answer, and it’s offensive to suggest otherwise.

What’s happening with the tender for the trauma specialist counselling part of the service?

MHS has been contracted to manage the 1800RESPECT service since 2010. MHS subcontracts R&DVSA to provide the trauma specialist counselling service. The contract between MHS and R&DVSA expires on 30 June 2017 and MHS made the decision to tender for the trauma specialist component of the service. All aspects of the tender are the sole responsibility of MHS as per its contractual arrangements with the Department. The Department is aware an independent probity advisor is overseeing the tender process. A sector expert with experience working in the family and domestic violence sector including crisis lines will be on the evaluation panel.

Throughout the procurement process, callers will continue to have full access to trauma specialist counselling and there won’t be a reduction in call or service quality.