Sexual Harm Crisis Support Service Guidelines F21 - MSD

This investment will help to create a more integrated, efficient and responsive system tothose affected by sexual violence, by continuing and building on sexual violence servicesimplemented since Budget 2016. It will mean more people get the services they need,when they need them.Why do we purchase crisis support services?The Ministry purchases the provision of specialist sexual harm crisis support services inorder to provide immediate support to those impacted by sexual harm and reduce thedevastating longer-term impacts that sexual harm has on adults, their families, whānauand communities across the country.The Ministry’s investment strategy in relation to crisis support services is to ensure theprovision of sustainable, effective and well-co-ordinated services that are available andaccessible for adults (and their family, whānau and community) who have been affectedby sexual harm.What are the outcomes we want to achieve?For crisis support services, the Ministry would like to see the following outcomes: national coverage and accessible services more immediate disclosures and supportive responses for victims/survivors, theirfamily and whānau2 physical, emotional and psychological safety for victims/survivors increased self-esteem/efficacy and restoration of mana.In turn, these outcomes will contribute to the longer-term outcomes of: early disclosures and more immediate positive responses to victims/survivors ofsexual harm reduced long-term impacts for victims/survivors and greater resiliency/productivity enhanced community awareness and pro-social responding to sexual harm.With the ultimate goal of: safe, attentive and responsive communities of care healthier individuals, families and whānau, and more vibrant communities a decrease in sexual harm within communities and an increase in victim/survivorwellbeing a reduction in costs of sexual harm impacts on society.(See Part 8 – Measuring results and reporting for more information on outcomes.)2In referencing whānau in these Guidelines, it is important to note that this is not merely anextension of family, but people weaved together through whakapapa over multiple generationsand across hapū/iwi.8

4. Service overviewWhat are sexual harm crisis support services?Crisis support services are specialist sexual harm crisis interventions that operate froman indigenous worldview, are culturally effective and based on established principles ofgood practice.Providers will be contracted to provide psycho-social crisis support services. Theseservices take a trauma-informed approach to service provision and include: advocacy and support (including callout) emergency face-to-face sessions (including crisis counselling) crisis social work support.Crisis for this purpose, is not defined by an actual event, but by a person’s (and theirfamily, whānau and community’s) response to that event. A response can happenimmediately after the event or be triggered at multiple points beyond that event.The services being described here as crisis support services are those required by avictim/survivor, their family and whānau during or following a crisis. These services needto be: immediately available and accessible to all victims/survivors, with sufficient specialiststaff to respond at no cost to the victim/survivor available 24/7, 365 days a year where possible (as sexual harm can occur at anytime, but anecdotal evidence suggest it is more likely to happen at night. Flashbacksand nightmares, and disabling terror can happen anytime, but also often occur atnight) linked into local communities so appropriate referrals can be made.Given the nature of sexual harm and its on-going impacts for many victims/survivors,the importance of accessible services and an immediate response capability cannot beover-estimated. It is known that many incidents of sexual harm are not reported andthat many survivors do not disclose until years after the fact, if they disclose at all.These crisis support services are part of a broader suite of sexual harm support servicesthat aim to support adult victims/survivors who are in a place of crisis in response toimmediate and/or historic sexual harm.Who are the services targeted at?Crisis support services are delivered in a community setting to people who have beenaffected by sexual harm.For the purposes of these Guidelines the scope for providers is to deliver services foradults (18 and over), with capability to also support their families and whānau in thecontext of supporting the primary adult victim/survivor.Oranga Tamariki contracts with providers to support children and young people affectedby sexual violence.Providers will have internal capability and/or strong interagency links to other servicesthat are able to work with children.Who can deliver crisis support services?9

Victims/survivors, family, whānau and communities are best serviced by specialistservices due to the particular dynamics and high-level impacts from sexual harm.The provision of crisis support services is a specialist service, delivered by providers thathave relevant qualifications and/or specialist training and knowledge about sexual harmand interventions based on researched good practice.Providers must be able to provide safe and high-quality responses to clients during andimmediately following a crisis.A specialist sexual harm service provider has been defined as:“. a non-government organisation that provides services with a sole or primary focuson delivering psycho-social support to people affected by sexual violence”3Also within more generalist non-government organisations there may be staff withspecialist capability who are able to provide safe, high quality support to those affectedby sexual harm (eg ACC approved providers, staff with previous specialist sexual harmsupport experience).(See Part 7 - Workforce capability and support for more information on who candeliver services).Social Sector Accreditation StandardsProviders who deliver crisis support services are required to meet Level 2, Ministry ofSocial Development Accreditation Standards.Providers are required to maintain their Approval Level according to the Ministry’srelevant Approval and Accreditation Standards.Who is involved?The clientThe client is at the centre of all services. A client is defined as an adult (18 and over)victim/survivor who agrees to engage with the Provider for support through a sexualharm crisis event. In supporting the client, support may also be required for their familyand whānau.Providers and the specialist workforce will recognise the diversity of clients and types ofharm and deliver services in a way that is responsive to the needs of the client.The client will be actively informed and consulted about the support that is available tomeet their needs. The client’s needs are the most important determinant of whathappens.The ProviderIn addition to carrying out all requirements and responsibilities outlined in the OutcomeAgreement and these Guidelines, the role of the Provider is to: employ and support specialist and appropriate staff operate a viable service that is able to support all staff and their professionaldevelopment, in accordance with the Ministry’s Approval and Accreditation Standardsand these Guidelines ensure appropriate community collaboration and networking links are made tosupport clients3As defined by Te Ohaakii A Hine – National Network Ending Sexual Violence Together (TOAHNNEST)10

actively participate in any regional networking, information sharing and knowledgebuilding activities develop and maintain effective collaborative working relationships with regionalMinistry sites participate in training and up-skilling activities to keep up to date with development,innovations and good practice in the development and delivery of crisis supportservices provide and enable access to training and development opportunities as well asregular supervision (in addition to individual supervision, cultural supervision will alsobe provided for all staff on a regular basis) ensure systems and processes are in place to utilise and report on delivery ofservices and funding in line with the Outcome Agreement and these Guidelines.The Ministry of Social DevelopmentThe role of the Ministry is to: approve providers monitor the performance and contractual management of the Provider seek and support continuous improvement of service delivery, including updating ofthese Guidelines lead the development of outcomes and service guidelines ensure national coverage and quality through a fair and equitable funding allocationprocess.National Sexual Violence HelplineSafe to talk, Kōrero mai ka ora (Safe to talk), the national sexual violence helplineprovides free, confidential information and support to those impacted by sexual harmwherever and whenever they might need it. Information and support can be accessedvia phone, text message, email and the website, which includes webchat4.The Ministry expects that providers will interact with the helpline, which will include: receiving referrals from the helpline making referrals through the helpline to access and align with other availableservices providing information to clients, family and whānau about the helpline using the helpline for information and/or support.The helpline is not intended to inhibit a client’s ability to connect with regional servicesvia current local numbers already in operation. A client’s trust and relationship with theProvider is vital and should not be compromised by Safe to talk.The Joint VentureThe Government formed a Joint Venture for Family Violence and Sexual Violence (theJoint Venture) in September 2018. The Ministry is part of the Joint Venture along withnine other government agencies. The Joint Venture will set the future direction for crossagency work to address family violence, sexual violence and violence within whānau.4Safe to talk can be accessed by calling 0800 044 334, or by going to the website:www.safetotalk.nz11

5. Service deliveryHow will people access these services?People can self-refer or be referred to crisis support services.A referral may come from family and whānau and the community, Police, othercommunity organisations, health and forensic services, government agencies, and thenational sexual violence helpline, Safe to talk. Safe to talk can provide contact details5for local providers when requested and can make referrals through a three-way contact(warm handover) with the client, the provider and the helpline.Providers will ensure referral pathways into the service are visible and that barriers areminimised for people to access services. People in crisis need to be able to access theright support when they need it.This will include options for referral to a local Kaupapa Māori sexual harm service.Where no Kaupapa Māori service is available, or there is limited capacity, it may bepossible to refer to a local hapū/iwi as to who has specialist training and is capable ofworking with Māori victims/survivors of sexual harm in that area.The client will be given information about what to expect when they access the service,including informed-consent processes, collection and storage of personal information,confidentiality and limits to confidentiality. This information is also available for theclient’s family and whānau if they are involved as a support network.Providers will collect sufficient and appropriate information in order to support the client,their family and whānau.Providers must have processes in place for making referrals to other agencies andservices, including keeping records of referrals.Coverage of servicesThe Ministry purchases nationwide coverage of crisis support services.Providers will have processes in place to ensure adequate service coverage across theirtarget area(s), as stated in their Outcome Agreement.Charging for servicesThe Provider will not charge clients for the delivery of the crisis support servicesspecified in these Guidelines.How will providers engage with people?Crisis support services work to protect, promote and enhance the wellbeing ofvictims/survivors, their families and whānau by making sure their needs are heard andmet. A specialist response to sexual harm is a ‘believing response’, one of nonjudgement and sensitive to a client’s state and sense of wellbeing (‘being with’ ratherthan ‘doing to’).Services are to be client-centred and whānau-centric. Services give autonomy, controland choice back to the client and ‘pace’ the work in a manageable way, including the useof a person’s own language, and supporting their immediate needs and goals.5Provider contact details are sourced through Healthpoint (https://www.healthpoint.co.nz/)12

The wellbeing of individual clients has to be (where possible) in the context of theirfamily and whānau and take a strengths-based, mana-enhancing approach. Thisapproach6 should underpin engagement with clients, their families and whānau.The following principles derived from Kaupapa orientated practice (specifically WhānauOra) articulate these ideas:Manaakitanga host victims/survivors, their family and whānau in a way that empowers them, andremoves barriers to access supportWhānaungatanga establish meaningful relationships in culturally appropriate and effective ways – andengage in a way that builds trust work with people, their family and whānau from a cooperative positionTino Rangatiratanga victims/survivors, their family and whānau have autonomy to decide how and whenthey participate in services victims/survivors, their family and whānau (where possible) are aided to makeinformed decisions about their support needs and options and given the utmostautonomy over their support processMana victims/survivors, their family and whānau are experts in their own lives – ensure thebalance of power through all interactions people, their families and whānau lead the conversation and their journeyAko learning is a two-way process - relationships are about learning from each other.How long does a client remain with the service?The nature of sexual harm crisis support does not fit within definitive timeframes and/ora ‘programmed’ delivery.Crisis is not defined by an actual event, but by a person’s (and their family and whānau)response to that event. A response can happen immediately after the event or betriggered at multiple times beyond the event.Providers will ensure a client is supported for as long as they are experiencing a state ofcrisis. A state of crisis has no set timeframe, it will last different lengths for differentvictims/survivors.Providers may have internal capacity to provide further care and recovery services 7. Ifnot they must have links to further care and recovery services8 and make active referralsto such services.‘Completion’ of services will be a joint agreement between the client and Provider. Ifthere has been no contact from the client for a period of no less than four (4) months,the ‘file’ will be considered closed 9. If that client later accesses services, they are thencounted again as a returning client.6789Derived from the whānau-centric framework developed by the Southern Initiative.Any further care and recovery services are not covered by the contents of this guideline.Such as Integrated Services for Sensitive Claims (ISSC) through ACC.If that client later accesses services they are then counted again.13

What do services focus on?Crisis support services provide support to clients affected by sexual harm, and theirfamily and whānau. This support is to meet a

Feedback on the Guidelines is welcome at any time and can be sent to the Ministry's National Office using the feedback form (Appendix 1). Revision of Guidelines for F21 These guidelines are a revision of the original F18 Sexual Harm Crisis Support Guidelines. The Ministry has updated the Guidelines to ensure they are relevant to the