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Independent Advocacy SA Inc
99 Frome Street Adelaide SA 5000
Telephone (08) 8232 6200 Facsimile (08) 8232 6255 Freecall: 1800 999 884 Email: indepadv6@intemode.on.net
30/12/2022
Dear Commissioners,
I write to provide The Commission with observations and recommendations regarding marginalisation. This topic was touched upon and discussed in the evidence presented during Public Hearing 14 held in Adelaide.
I am employed by Independent Advocacy SA Inc. as a Disability Royal Commission Advocate for people with an intellectual disability, and others where possible. Independent Advocacy (IA) has been advocating for people with an intellectual disability since 1986. The model of social advocacy undertaken by IA is intensive and long term in response to situations of extreme marginalisation and complexity. Much of the work we do is advocating to human services to protect the marginalised person from further harm and to ensure that they receive appropriate support and service.
IA is funded under the Federal Government’s National Disability Advocacy Program (NDAP) through the Department of Social Services (DSS). The NDAP funds organisations to advocate for vulnerable people with disability. IA is also funded through DSS to undertake Disability Royal Commission Advocacy support.
During Public Hearing 14 we heard evidence from both the CEO of the NDIA and the Commissioner of the Quality and Safeguards Commission. They were both questioned on the Vulnerable Participant’s Framework that was developed as a response to both the COVID-19 Virus and the appalling circumstances of Ann-Marie Smith’s death. IA believes, based on the evidence presented at the hearing, that the Vulnerable Participants Framework can be an important tool in identifying marginalized individuals and subsequently building appropriate support and safeguards around them. To this end IA would like to provide the Commission with an example of what a robust evaluation of risk factors requires, along with further insight on factors that increase the risk that marginalized people face. We would also like to share a recent experience of someone we advocate for to highlight how current processes can be improved.
a Vulnerability Indicator Guide that was developed by National Disability Services. The guide contains many of the factors we would consider when evaluating a person’s risk, and as such this submission will not break down all of the risk factors presented within. However, rather than recommending the document be adopted as-is by the NDIA, we would instead like to highlight the overall structure and thinking behind the guide that make it an effective tool.
The introduction section covers points that give clear guidance on the thinking and motivation required to use the document, as well as making it clear that the guide is only a tool; it is not a solution in and of itself Some of the key takeaways include the guide explicitly stating that it is not a substitute for building relationships with people to uncover their individual needs, and that vulnerability can be context specific, impacted by previous trauma and the specific attributes of the person.
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The guide also stresses that merely noting that a person is vulnerable or that an incident has occurred is NOT sufficient, and that based on the information gathered additional supports and services should be considered to help mitigate some of the risk (as opposed to measures that only identify abuse and neglect after the fact, such as welfare checks).
The use of supporting questions and considerations is another feature that makes this tool highly effective. It supplements the scored questions and encourages the person using the tool to consider more deeply the indicators and factors that may lead to a person being marginalized, rather than a tick-box exercise. This is especially important for people with an intellectual disability, and even more so when the person assessing does not already have a pre-existing relationship with the person. As an example, there is a scored question within the guide that asks if a person has unpaid relationships. On the surface, having a large number of unpaid relationships may indicate a person may be less marginalised, and may be given a score of “Yes”. However, the supporting questions encourage a more critical look at the people within a person’s unpaid network, and makes it clear that a person may still need safeguards if some relationships are exploitative or abusive in nature. The guide also stresses that if the answer to any of the questions posed is “unsure” than that means more information needs to be obtained; it is not sufficient to just move on, ignore the factor or guess.
The notes section reinforces the idea that all primary and supporting questions should be addressed, and there is a section for specific concerns to be noted and linked directly to targeted safeguarding actions.
The guide stresses that as much as possible the person themselves has been involved, but also that family, friends and allies have been involved as well. This factor is especially important for people with an intellectual disability, as they may not hold all of their history or be able to effectively communicate all their circumstances.
The guide provided identifies 4 broad categories of vulnerability that a person may experience: decision making, financial, social, and health and wellbeing. There are a few points that IA would consider that are additional to those already made within the guide. Firstly, while the guide does acknowledge that not all unpaid relationships are positive, it is worth noting that even when the relationships are positive a person may still need additional support to keep them safe. Often allies of people with a disability can become fatigued or overwhelmed when they have been required to constantly battle against systems to improve the life of the person with a disability. Or there may be a willingness to assist, but other factors (such as distance, other commitments, or technical knowledge) may mean that the actual assistance they can offer is limited. Hence it is important to ensure that the existence of an unpaid support network should not immediately rule out the need for additional support. IA would also encourage deeper thinking when people are considering if a person is accepted by the wider community. Congregated activities, such as day programs, sheltered workshops and disability specific clubs and social outings, should not be considered sufficient community involvement. Indeed, this congregation and segregation can negatively impact the image of the person within the broader community and lead to even greater risk. It is worth keeping in mind that people with intellectual or psychosocial disabilities may have a worse image within the broader community due to outsider observers incorrectly assuming that a person’s negative actions are wilful rather than a result of their impairment.
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We would also explore more deeply the impact of trauma inflicted, and how that can impact a person’s vulnerability. The guide has a thorough appendix identifying abuse and its indicators. However, this is presented as supplementary information. It would be beneficial to have a deeper reflection on the trauma people have experienced and consider actions that will minimise further trauma; especially systemic trauma that has been inflicted by particular organisations/government departments that the person regularly interacts with. As a final point on trauma, IA would add that extreme compliance can be an indicator of abuse and neglect.
As important as it is to identify those who have heightened risk of experiencing violence, abuse, neglect and exploitation, it cannot be the end of the process. Once risk factors have been identified there needs to be tangible plans and actions taken to address the factors indicated, which we do not believe is occurring currently. A person we advocate for has recently had a planning meeting where their vulnerability factors were discussed, and through this discussion multiple factors were identified that demonstrated the person was at risk due to their current circumstances. However, the plan that the person received did not seem to acknowledge the risks the person is facing, and there seems to be no consideration of extra support or funding to help safeguard the person. Safeguarding a person means more than just a welfare check or passive observation. Any assessment of vulnerability should prompt further consideration of additional supports, support coordination or specialist support coordination that may need to be funded within a plan to address risk factors identified.
As a final, separate point on the evidence presented in the hearing, Commissioner McEwan asked the question to Mr. Bruggemann about having individual advocacy funded under a person’s plan. While having individual advocacy resourced and funded to the point where all participants can access advocacy freely and without wait lists is a commendable goal, Independent Advocacy would NOT support this funding being tied to an NDIS plan, for a few reasons. Having a set amount of advocacy funded per individual has the potential to limit the amount of time advocates are able to spend with one person. This may result in advocacy efforts being reactive and crisis-driven, with little scope to “ensure the good things happen” for people with a disability. The potential for advocacy funding to be exhausted before fully or appropriately resolving an issue could also result in disastrous and unintended consequences for the person being advocated for. In addition to these points, having funding tied to the NDIS also undermines the independence, and therefore the efficacy, of advocacy itself However, this will be discussed in greater detail within a future submission to the Commission regarding the Importance and Independence of Advocacy.
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IA is willing, and looks forward to, discussing these factors with regard to people with an intellectual disability with the Commission. This is particularly important given that many of the people we advocate for will be unable, due to issues of capacity, marginalization and trauma, to speak directly to the Commission in relation to their experiences.
Kind Regards
Michael Cowley
Disability Royal Commission Advocate
p.p. Fiona Campbell
Coordinator
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