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300 Australians that no one wants

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I was apprehensive before meeting Will. I knew a little bit about him and most of it wasn’t good. Categorised as a ‘complex psycho-social individual given to extreme behaviours’, Will had spent the best part of 20 years detained and secluded, 24/7, in a forensic disability facility. He was deemed a danger to the community, his carers and himself.

Prior to coming into the care and support of his new provider, Fina Australia (formerly SCOPE Inc), Will’s behaviour was marked by frequent episodes of verbal aggression, serious assault, property damage and highly inappropriate, sexualised behaviours. Will’s abscondences were of significant concern given some evidence of sexual interest in pre-pubescent females. When he first transitioned to Fina, Will frequently resorted to highly aggressive behaviour, presumably in an attempt to wrest back some control over his life. The more I learned about Will and how he ended up in this facility, the more sympathy I had for him playing the only card in his hand.

Apart from my work in the music industry, for over 20 years now I’ve been a member of a small team working on corporate rescues and organisational change projects. We’ve done work for local and state government entities, Indigenous organisations and a couple of big Australian companies. In 2019 our team was retained by the Management Committee of Fina Australia, a not-for-profit disability services organisation based in Queensland.

As we restructured the organisation, we saw an opportunity to reimagine the care and support of people subject to forensic disability orders, described as ‘complex psycho-social individuals given to extreme behaviours’.  

This is the road that led me to Will. As a singer-songwriter, I’ve performed in prisons over the years. Getting in to see Will was pretty much the same: one robust security door opened and closed before the next one opened. I emerged into Will’s outdoor area, about 150 square metres of what once might have been lawn surrounded by an 8-metre high security fence. In one corner Will had gouged out a pretty deep hole in a fruitless attempt to burrow underneath the wire.

Will was taller than I expected, tanned with a potbelly and long, thin, scraggly hair. Dressed only in shapeless tracksuit pants, it was obvious that his muscle tone and posture were poor. He didn’t walk so much as shuffle along in scruffy sneakers which had seen better days. Will’s dental health was appalling: his visible teeth were in an advanced state of decay and his personal hygiene left much to be desired. I was told this was a deliberate tactic to dissuade previous carers from man-handling him. Occasionally, he would smear himself with his own faeces, thought by some as an effort to make himself unattractive to sexual predators.

Will had been in the care of Fina for about 12 months and I could scarcely reconcile the man standing alongside me in the yard with the one who had been documented as violent and abusive only a year earlier. We chatted about some of his recent progress and I later discovered that he’d gently sent me up by pretending that he’d chalked the mural on the outside wall that I had remarked on (which had in fact been done by his lead carer Scott). About 20 minutes later, I said goodbye and Will shuffled back into his dark living area, presumably to get back to his Xbox. The door was left open. In Fina’s care, he is seldom secluded these days.

Being with Will in his cage for 20 minutes was a sobering experience and an abject lesson in institutionalisation and dehumanisation. The compassionate director of his forensic disability accommodation scratched out for me a mud map of Will’s path through his life to date.

 

'Will and 300 people like him are the Australians that no one wants. Through no fault of their own, they’re subject to indefinite detention and long periods of seclusion. The system makes them worse, not better.'

 

Will was the son of an overseas serviceman and an Australian woman. Will was highly autistic (presumably Level 2 or 3) and his father was given to domestic violence. The father and the autistic son clashed and, in turn, Will took out his frustrations on his younger sisters. Normal school was a disaster. At the age of about 12, he was made a ward of the state and went into foster care. When he was old enough, he was removed from foster care and placed into the supported independent living system where his life was fairly stable for a while. No one can say for sure but there are indications that Will was abused in one or both systems. At 18 years of age, Will was charged with illegal use of a motor vehicle. Given his autism, he was given over to the disability/mental health sector rather than the correctional system. And that’s when the real trouble started — almost 20 years of containment and seclusion precipitating his violent, abusive and destructive behaviour.

There are approximately 300 Australians like Will currently held in forensic disability facilities, hospitals, mental health facilities, the prison system and providers of last resort. Their lives are marked by containment, seclusion and chemical and physical restraint. No one wants them — they clog up entire hospital wards in between being shunted between various providers: the NDIS, Public Guardians, mental health agencies, correctional facilities and various state Social Services departments. Ordinary, periodic re-assessments of people like Will are often stymied by the agencies to which they might be transferred on the basis of the outcome.

Each time these people are shunted around, any developmental progress made previously, however minor, is lost. It’s not an overstatement to say that far too many of these people are treated like animals.

Since coming into the care of Fina a little over a year ago, Will has gradually unlearned some of his previous behaviours. In May this year he was secluded for only 5 hours across the whole month, and every month since then has been an improvement. Previously, he was regularly secluded for between 22 and 24 hours per day. Now that he’s supported by Fina’s trained and stable team of carers, Will is able to enjoy previously unimaginable activities such as trips to the precinct pool and barbecues with his carers. Recently, he even assisted with mowing the grass in his enclosure.

The Fina ‘step down’ methodology is centred around his carers’ planned engagements with him as opposed to locking him up on his own (secluding him). Surprise, surprise! Will’s ‘behaviours’ are now markedly fewer and less severe. Meticulous observation, recording and data analysis enable his team to predict and manage his behaviours before they escalate. This method is proving to be successful with Will and, indeed, a number of other complex psycho-social individuals in Fina’s care.

However, caring for these people and improving their lives is not without its challenges. There are myriad rules and regulations governing the care and support of complex psycho-social individuals. These rules and regulations are complicated, often contradictory and mired in bureaucratic power games. The actual provider has little or no power and is at the mercy of agencies that often vie with each other for supremacy, with little or no regard for the individual at the centre.

Some government agencies and bureaucrats are unfamiliar with the daily reality of caring for these people. Their engagements with the provider are marked by suspicion, regulatory heavy-handedness and a disappointing unwillingness to cooperate. It is difficult to see how an agency that issues an endless stream of infringement notices contributes to anything other than burdensome compliance costs and the diversion of scarce resources.

When discussions were underway about taking over Will’s care, Fina argued that, initially, higher-level restrictive practices would be necessary. This was strongly resisted by two stakeholders: Will’s family members and the NDIS Quality and Safeguard Commission (Qld).

However, the eminent behavioural psychologists advising Fina were clear that Will’s transition into an unfamiliar setting and the sudden removal of restrictions could well result in serious harm to him, his carers or members of the community. Fina and the behavioural specialists prevailed and Will’s rapid progress under Fina’s care and methodology proved them correct.  

We are all aware that disability funding packages are fraught. Not all aspects of the care and support required by complex psycho-social individuals qualify for NDIS funding, so there are plenty of funding cracks for people like Will to fall through. Rather than cooperating to fix these cracks, some agencies appear to be primarily invested in perpetuating them, thus avoiding costs and responsibility. At the same time, an individual’s funding can be quickly exhausted by providers and professionals across a range of services. It’s no news to anyone that the NDIS is seen as a gravy train.

Unsurprisingly, the robust accommodation facilities these people are confined in look and feel like medium/high security correctional facilities. When Dostoevsky said, ‘The degree of civilisation in a society can be judged by entering its prisons’, he might well have included Australia’s forensic disability facilities.

Also unsurprisingly, success in bringing these complex psycho-social individuals ‘out’ is very much dependent on the nature of their environment. We all accept that our moods and behaviour are enhanced by light, fresh air and aesthetically pleasing surroundings. But we consign these people to cages and living areas lacking any aesthetic whatsoever, marked by smeary, shatterproof windows and scruffy, indestructible walls and doors. Yet we wonder why their behaviours and mental states do not improve.

Fina has developed a proven methodology and an associated training regime for specialised carers and support workers. Now, Fina is working closely with a specialty disability building and development company on the design and construction of a bespoke robust accommodation solution marked by light, fresh air and a sense of openness.

There is nothing like these accommodation facilities in Australia though the unmet demand is considerable. For every vacancy in a robust facility capable of containment and seclusion, there are at least 20 eligible applicants. One director of a forensic disability precinct in which every unit is occupied told me that, in that state alone, there were over 100 people waiting for a vacancy. These people, judged to warrant containment and periodic seclusion for their safety and that of the community, are currently accommodated in hospitals, mental health facilities and prisons.

Against this backdrop, Fina says in five years it could build bespoke facilities for 50 complex psycho-social individuals for about $40 million. Once built, and taking into account current direct and indirect costs, Fina estimates it can accommodate and deliver trained care and support to these people for about 50 per cent less than it currently costs the taxpayer. More importantly, living conditions, and therefore lives, are dramatically improved. But our experience is that getting politicians and bureaucrats to even consider that there might be a better way is challenging.

Will and 300 people like him are the Australians that no one wants. Through no fault of their own, they’re subject to indefinite detention and long periods of seclusion. The system makes them worse, not better.

Someone once said that a society can be judged by the way it treats its most vulnerable. If that’s right, Australia is not looking so good. But there’s a better way.

 

 


John Schumann is a South Australian singer-songwriter, best known for his leadership of the legendary folk-rock band Redgum and his Vietnam veterans’ anthem, 'I was only 19'.

Topic tags: John Schumann, Disability, Restraint, Reform, Prison, Disability services, Fina

 

 

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Existing comments

A vital part of the Benedictus lets us experience that "In the tender compassion of our God the dawn from on high shall break upon us". This means a change for all humanity: the kings, the presidents, the prime ministers, the governments, the professions, the working men and women, all people who walk a path. So much of Will's life is controlled; necessarily to protect him and to protect others. Forensic analysis of Will's behaviours allows other people to help him adjust to what he sees as a strange and fearsome world. However, as good and noble as this goal is it could well be that our 'normal' perceptions are only a breath away from Will's existence.


Pam | 24 October 2024  

One of the more enlightened critiques of disability and difference that I have read in a long time!

Why is it that the Scandinavians, with their bleak winters, their determined take on 'This World' rather than 'The Next', and their strong focus on the Welfare State, can handle these challenges so much better than we do?


Michael Furtado | 25 October 2024  

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