ONE – INCREASE THE LEVEL OF RECOGNITION OF CARERS
While rewarding, caring for others can be a demanding and difficult role that has many challenges. Research shows that carers have higher levels of depression, financial strain and social isolation than the average Australian.
Carers make a significant contribution to the health and wellbeing of Tasmanians in need of support and assistance. They deserve recognition for what they do in our communities and the value they have in our society.
Carers are usually friends or family of the person in need and are often their main care-givers. They may not be easily identifiable and therefore may not be known to carer agencies and services, or receive support for their caring role.
Children and young people who are carers can be at particular risk of not being recognised and treated as people who are providing care.
What the consultation told us:
Carers want greater awareness and recognition of who they are and what they do, the reality of the caring role, and the diversity of caring roles and requirements:
- across government (departments and Members of Parliament (MP);
- in the community;
- in the community sector;
- by employers of carers;
- in hospitals and health services; and
- in schools.
Some carers are concerned the definition of carer in the current Carer Policy is worded in a way that is confusing and leaves them feeling excluded and unrecognised.
What we are currently doing:
Through the Department of Premier and Cabinet (DPAC), the Government funds Carers Tasmania to promote awareness and recognition of carers, and to provide support services for carers. Through the Department of Health and Human Services (DHHS), the Government funds MHCTas to provide information to carers of people with mental illness and build their capacity to participate and advocate. This Government funding also supports MHCTas’ systemic advocacy roles, including engaging family/carer representatives in mental health initiatives and committees. The Mental Health, Alcohol and Drug Directorate (MHADD) in DHHS promotes carer organisations to its staff, and to clinical services within its areas of responsibility (Mental Health Services, Alcohol and Drug Services, Forensic Mental Health Services and Correctional Primary Health). This is done through the Senior Consumer and Carer Liaison Consultant role, and by family/carer representatives engaged within services.
Government departments actively promote support available to carers to their staff. This includes induction packages, staff newsletters, and management training to ensure that managers and colleagues are aware of their rights as carers, responsibilities of employees with caring responsibilities and where to find resources to support them.
Several departments take part in Carers Week to promote carer awareness and recognition, and are proactive in expanding the scope and nature of these activities. For example, DHHS is developing case studies of employees and clients with caring responsibilities to raise awareness of the role of carers and the support available to them in the workplace.
As the employer of one of the largest workforces in the state, the Tasmanian State Service’s Diversity and Inclusion Policy and Framework applies to all Tasmanian State Service employees and officers. The Framework provides contemporary resources and support for employees and officers who are carers, and those who work with and supervise them. This work is undertaken by DPAC’s State Service Management Office (SSMO).
Government departments that work directly with carer clients undertake activities to promote carer awareness and recognition. The Department of Education (DoE) helps to raise awareness within its organisation and the community of the needs and priorities of student carers. It produces brochures and website material containing relevant information such as contact details for support organisations. Following the implementation of the Education Act 2016, DoE has developed an Attendance Policy and Process that directs schools to contact parents and/or independent students following a student’s unexplained absence from school. This may identify that caring responsibilities are the reason for the absence, and allow the school to provide appropriate supports for the student to minimise absences and enable regular attendance at school.
“Caring is an isolating role, you lose track of family, friends, and the rest of the community.”
– attendee at National Carers Week 2016 Forum, Tasmania
Support Carers Tasmania and MHCTas to raise community awareness of carers, including the valuable contribution they make and the challenges they face.
DPAC and DHHS
Organise annual Department sponsored events during Carers Week to recognise employees who have caring responsibilities and celebrate the carers in the community.
Promote Carers Week on the DPAC website and encourage other departments to also promote Carers Week.
Implement the DoE Attendance Policy and Process to help schools identify when caring responsibilities are the reason for a student’s unexplained absence from school.
Review the definition of carer in the Carer Policy, in consultation with key agencies and community organisations, so all carers affected by the Carer Policy see themselves and their role in the definition.
As part of the Diversity and Inclusion Policy and Framework, monitor activities that promote awareness of caring responsibilities Tasmanian State Service employees and officers may have.
Work with frontline government services that engage with carers to explore how they can embed awareness of carer needs, and how these differ across diverse groups of carers.
TWO – IMPROVE THE LEVEL OF SUPPORT AND SERVICES TO CARERS
In a long term study of the Australian Unity wellbeing index, the low levels of wellbeing among carers is noted as a significant concern. To care safely and maintain their own physical and mental health and wellbeing, carers need information, support, respect and recognition from the professionals with whom they are in contact. Receiving information, support, respect and recognition within their work and social settings can be equally important.
Carers need support to balance their work and caring roles or to return to work if they have lost employment due to caring. After their caring responsibilities have ended, carers may need help to rebuild a life of their own and reconnect with other family members, education, work or a social life.
Demographic trends and modelling show the demand for informal care is increasing at a faster rate than its supply. Being responsive to the needs of carers and care recipients alike will be important to help address this, including offering greater flexibility in working arrangements to accommodate workers’ caring responsibilities and employment preferences, and encouraging use and awareness of carer support services that alleviate the impact of caring.
What the consultation told us:
Carers expressed a need for more specific support services, independent of those for whom they care. In particular, carers said they would like more information about and access to respite and opportunities to spend time with other carers.
Carers also felt that mainstream services they engage with could better understand and be more responsive to their needs by considering them, offering them support, information, and referral to services.
What we are currently doing:
In acknowledging that many of the key payments and services provided to carers are delivered by the Australian Government and the community sector, the Tasmanian Government will continue to work collaboratively to improve outcomes for Tasmanian carers and those for whom they care.
As an employer, the Tasmanian State Service is committed to having a diverse workforce and to building inclusive workplaces where all employees feel welcomed, safe and supported. Tasmanian State Service employees have access to leave provisions to assist with caring responsibilities. Employees may be able to negotiate flexible work arrangements. A State Service employee who is providing support to a person who is a member of the employee’s immediate family or household and who is, or has been, experiencing family violence, may also be granted personal leave.
The State Service has an Employee Assistance Program that offers confidential counselling sessions for employees and officers regarding personal, family or work related issues. This work is led by DPAC’s SSMO.
DPAC administers the Tasmanian Companion Card Program, which entitles eligible people with life-long disability who need a carer to participate in community activities to a free ticket for their companion carer to participating venues and events. Government cultural events and venues, like the Tasmanian Museum and Art Gallery and events held by Arts Tasmania and Screen Tasmania also encourage and support the use of the Companion Card. The Companion Card program is increasingly doing on-site assessments, providing a more accessible face-to-face approach for applicants seeking acceptance to the program, particularly regional applicants.
The number of new Companion Cards issued to Tasmanians with lifelong disability who require a companion carer to participate in community activities has increased steadily over the past five years from – 180 new cards in 2012-13 to 290 new cards in 2016-17. Much of the increase can be attributed to improved awareness of the program and the introduction of the National Disability Insurance Scheme (NDIS), which has increased funding to enable more participation in community events by people with lifelong disability.
In addition to its work promoting carer awareness and recognition, MHADD in DHHS continues to deliver a number of initiatives to strengthen and improve the delivery of carer supports and services, including:
- providing overarching policy and training to public mental health services to work effectively with carers of people with a mental illness (implementation of A Practical Guide for Working with Carers of People with a Mental Illness 2016);
- supporting clinical services to work in partnership with family members and carers in clinical practice, policy, planning and evaluation; and
- providing ongoing funding to the National Mental Health Consumer and Carer Forum to provide state representation from a mental health carer lived experience into national systemic advocacy and policy development (www.nmhccf.org.au).
MHADD supported the 2017 International Initiative on Mental Health Leadership (IIMHL) Exchange, with the Directorate’s Senior Consumer and Carer Liaison Consultant hosting an international leadership exchange in Launceston. Delegates explored the concept of Family and Carer Leadership in Mental Health and presented a synopsis of the exchange to the IIMHL Conference in Sydney.
The Disability and Community Services Branch in DHHS continues to fund services that support grandparents (or relative carers) who are the primary carers for their grandchildren. These services are provided via funding agreements with community partners Baptcare and Mission Australia.
Activities related to this program include:
- brief intervention or short term support to assist adjusting to the role of being a primary carer;
- providing information, advice and referral, especially during the initial period during which they have taken on the role of primary carer;
- providing access to family support services, where required, to enable brief intervention and episodic support to address family conflict and other interpersonal tensions;
- managing brokerage funds that grandparent or relative carers are able to access to cover the cost of essential items and support activities; and
- providing a range of group based activities or information sessions.
Tasmanian Home and Community Care (HACC) work with carer peak bodies to identify gaps in services; plan services and programs; and fund services that:
- provide information and counselling to carers;
- provide respite for carers; and
- enable carers to escort family members using HACC community transport.
DoE recognises the impact that wellbeing has on the success of Tasmania’s children and young people as learners. While support staff, targeted programs and flexible learning opportunities can benefit all students, they provide valuable support to student carers:
- DoE has established the Child and Student Wellbeing Unit and has allocated $1.6 million over four years to improve wellbeing and educational outcomes for children and young people in Tasmanian Government schools. As a priority it will deliver a Child and Student Wellbeing Strategy to identify actions to address gaps and improve wellbeing through primary prevention, early intervention and targeted support.
- In Tasmanian Government schools, support staff include support teachers, school psychologists, speech and language pathologists, and social workers who can help to identify and support specific needs (e.g. emotional and developmental) and may also refer students to other professional supports if required.
- DoE uses data to identify possible student disengagement early and to initiate prompt restorative action through successful re-engagement programs and flexible learning opportunities.
Through the Government’s policy for training and workforce development, Investing in Skills for Growth, the Department of State Growth works with vulnerable Tasmanians to participate in the workforce and build their employability skills. This includes offering work readiness programs that target skills development to real needs of workplaces and create pathways through to qualifications for Tasmanians facing barriers to training and employment.
The Training and Work Pathways Program funds innovative projects that enhance vocational education and training and employment options for disadvantaged Tasmanians, and expand and sustain learning opportunities. These projects can include training, research related to vocational pathways, and brokering partnerships between community organisations, industry, employers and training organisations to meet the needs of Tasmanians facing barriers.
Tasmanians with caring responsibilities are an identified target group within this program.
“The paradox of being: when you need to engage with external support, you have the least internal resources to do so.”
– mental health carer
On an annual basis, continue to work with Carers Tasmania and other key carer support organisations to find ways to ensure carers know about available supports and services.
DPAC and DHHS
Ensure Tasmanian State Service employees/officers with caring responsibilities and their colleagues have access to contemporary and relevant resources that support flexible workplaces.
Develop a Carers’ Toolkit for Tasmanian State Service employees, officers and managers that provides guidance about work arrangements and support.
Work with the CIRG to identify gaps and avenues for better promotion of supports that are available to carers.
Continue to administer and expand the Companion Card program.
Develop a Child and Student Wellbeing Strategy for release in 2018.
Provide additional professional support staff (14.8 additional Full Time Equivalents over four years) to support the health, wellbeing and learning needs of Tasmanian students, including student carers.
This includes $6.9 million over four years for additional speech and language pathologists, school psychologists, and social workers in Tasmanian Government schools.
Build and extend successful student re-engagement programs delivered by DoE.
$5 million is allocated over four years.
Seek advice from the Carer Issues Reference Group on how information that is timely, simple and free of jargon can reach carers.
Through Tasmania’s Active Ageing Plan 2017-2022 fund the Council on the Ageing Tasmania to deliver initiatives to improve digital inclusion for older Tasmanians.
Continue to recognise carers as a target group within the Training and Work Pathways Program, which aims to expand and sustain learning opportunities and employment options for disadvantaged Tasmanians.
THREE – INVOLVE CARERS IN THE DEVELOPMENT AND EVALUATION OF POLICIES, PROGRAMS AND SERVICES THAT AFFECT THEM AND THEIR CARING ROLE
It can be difficult for carers to contribute to the development and evaluation of policies, programs and services that affect them and their caring role. Their busy caring responsibilities can make it difficult to attend forums or take part in surveys that seek to hear their opinions and ideas. These responsibilities can also make it difficult for them to keep pace with and respond to the changing nature of how services and programs are provided to them as carers and to the person for whom they care.
In client-centred service delivery, decisions about the support provided to the client can affect their carer, and often require the carer’s support and cooperation. The involvement of the carer can benefit the service provider, as carers have a unique insight and first-hand knowledge of the needs and requirements of the person receiving care. In turn, the person receiving services can benefit from having their carer as part of a strong, trusting and well-informed care team. This outcome is at its best when the individual needs and circumstances of both the client and the carer are respected and taken into account.
What the consultations told us:
Throughout the community consultations, carers expressed a desire to engage more with government departments and decision makers. Carers wanted engagement to be meaningful, genuine, flexible and accessible. Carers also wanted to have their voices heard in their own right, not just in regards to the person they care for.
What we are currently doing:
The Government engages with carers through a number of mechanisms. The Government supports Carers Tasmania and MHCTas to represent the views of carers on an ongoing basis. A key component of the funding provided to these organisations is to consult with carers and inform government on how services are provided and policies are developed and implemented. These organisations are building the capacity of carers to engage directly with government and service providers. They are assisting government to communicate with people who can provide input into relevant policy, project and service development.
The Tasmanian Government actively consults carers and carer support organisations on specific projects, and seeks their representation on working groups and committees. For example, MHADD has consulted with Carers Tasmania and MHCTas to implement the Rethink Mental Health Strategy, a long-term plan for better mental health in Tasmania. It has also convened the Autism Advisory Panel, which includes carer representatives. The Panel provides recommendations to the Minister for Human Services on a long term strategy for Autism to give consideration to awareness, education and practical help for carers.
Carer representatives sit on the Premier’s Disability Advisory Council (PDAC) and the Minister’s Disability Advisory Council (MDAC), and present their views and perspectives on issues affecting people with disability for whom they care.
The Government also acknowledges the value of lived experience, with MHADD employing a Senior Consumer and Carer Liaison Consultant with lived experience to provide ongoing support and advice to public Mental Health Services, Alcohol and Drugs Services, Forensic Mental Health Services and Correctional Primary Health about working in partnership with carers.
The Australian Government delivers many programs and services to carers. It is leading the implementation of national reforms that affect carers, including the NDIS, My Aged Care and changes to the delivery of carer support services. Therefore, it is important the Tasmanian Government understands how these reforms impact Tasmania carers.
Through the CIRG established in August 2017, the Tasmanian Government has committed to collaborating and sharing information with Australian Government departments responsible for supporting carers, the National Disability Insurance Agency (NDIA) as well as Carers Tasmania and MHCTas which represent the views of carers. DHHS, through Disability and Community Services, also engages closely with the NDIA over transition to the NDIS, and its impact on people with disability and their carers.
“To feel important enough to be listened to with the wisdom we have learnt over the years being a Carer”
-mental health carer
Continue to fund and work with community sector organisations to build carer capacity and opportunities for carers to engage with government (departments and Ministers/MPs).
DPAC and DHHS
Coordinate the CIRG to ensure that the Tasmanian and Australian Governments, and key carer support and advocacy bodies, can share information and respond collaboratively to key issues affecting Tasmanian carers.
Audit how government engages with carers, to identify opportunities to better promote the accessibility of existing engagement mechanisms, and highlight areas that require more engagement.
Coordinate the PDAC and the MDAC with ongoing membership from carer representatives.
DPAC and DHHS