CROSS SECTOR INDUCTION AND ORIENTATION Alice Springs. 27 March 2014

Transcription

1 CROSS SECTOR INDUCTION AND ORIENTATION Alice Springs 27 March 2014

2 Numbers of NT Sexual Abuse Notifications and Substantiations to Notifications Substantiations Source: DCF

3 Substantiations by Type of Abuse/Neglect, to (percentages of total) 60% 50% 40% 30% 20% 10% 0% 51% 53% 49% 47% 40% 35% 28% 26% 26% 22% 24% 19% 20% 16% 17% 5% 10% 3% 8% 1% Source: DCF 2013 Neglect Emotional Physical Sexual 3

4 Number of notifications of Gonorrhoea and Chlamydia, age group, by year Gonorrhoea Chlamydia Source: NT Department of Health - Centre for Disease Control 4

5 Developmental hazards disproportionally faced by Aboriginal children in the NT Exposure to family violence Teen parenting (carer instability, poverty) Exposure to alcohol in utero Exposure to nicotine in utero Parental use of other substances Poor nutrition Various diseases such as otitis media, and anaemia Abuse and neglect

6 Hospitalisation rates per 1,000 for Indigenous children by category to Infectious and parasitic disease* Disease of the respitory system* Injury, Poisoning and other external causes* Nutritional anaemia ** Malnutrition** Source: CTG NT Monitoring Report (2013) * Children aged 0-14 **Children aged

7 The impact of developmental hazards faced by Aboriginal children in the NT Infant mortality rates 3 times those of other Australian infants Highest child death rates due to injury and accident Lowest school attendance/achievement Highest child and youth suicide rates Highest rates of developmental vulnerability

8 Percentages who are developmentally vulnerable on two or more domains of the AEDI % 50.0% 49.9% 40.0% 38.2% 30.0% 26.0% 20.0% 10.0% 10.8% 0.0% Australia All Australia Indigenous NT Indigenous NT Indigenous Very Remote Source: AEDI (2013) 8

9 Children who are developmentally vulnerable on two or more domains of the AEDI, 2009 and 2012 (percentages) 60.0% 54.3% 50.0% 46.8% 49.9% 40.0% 38.2% 30.0% 29.5% 26.0% % 10.0% 11.9% 10.8% 0.0% Australia Australia Indigenous NT Indigenous NT Indigenous Very Remote Source: AEDI (2010 & 2013) 9

10 NT Aboriginal children developmentally vulnerable on two or more domains by geolocation of the AEDI, 2009 and 2012 (percentages) 50.0% 45.0% 40.0% 45.4% 40.6% CHANGE: Darwin, Palm: - 0.1% Alice, Katherine: - 3.6% Remainder of NT: - 4.8% 35.0% 30.0% 25.0% 20.0% 24.9% 21.3% % 10.0% 12.3% 12.2% 5.0% 0.0% Darwin Palmerston and Darwin rural area Alice, Katherine, Tiwi Islands and Daly River area Remainder of NT Source: AEDI (2010 & 2013) Adapted from tables provided by DoE 10

11 NT Aboriginal children developmentally vulnerable by domains of the AEDI, 2009 and 2012 (percentages) 50.0% 45.0% 40.0% 35.0% 35.5% 33.7% 46.9% 42.4% 35.4% CHANGE: Physical: - 9.5% Social: - 9.2% Emotional: - 3.9% Language: - 4.5% Communication: - 9.1% 30.0% 25.0% 26.0% 24.5% 27.3% 23.4% 26.3% % % 10.0% 5.0% 0.0% Physical health and wellbeing Social competence Emotional maturity Language and cognitive skills (school based) Communications skills and general knowledge Source: AEDI (2010 & 2013) Adapted from tables provided by DoE 11

12 Trauma theory proposes that the origin of a significant proportion of physical, social, and moral disorder lies in the direct and indirect exposure to external traumatogenic agents Bloom & Farragher, 2011, p. 123

13 Adverse Childhood Experiences Study Household Dysfunction Substance abuse Parental separation/divorce Mental illness Battered mother Criminal Behavior Abuse Psychological Physical Sexual Neglect Emotional Physical

14 ACE STUDY DOSE-RESPONSE FINDINGS 18% % Reporitng Alcoholism 16% 14% 12% 10% 8% 6% 4% 2% 0% ACE Score We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors in adults Adapted from Felitti, VJ, Anda, RF et al (1998) 14

15 ACE STUDY DOSE-RESPONSE FINDINGS 20% % Reporitng IV Drug Use 40% 35% 30% 25% 20% 15% 10% 5% % Ever Attempting Suicide 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% ACE Score 0% ACE Score Source: Adapted from Felitti, VJ, Anda, RF et al (1998) 15

16 ACE STUDY DOSE-RESPONSE FINDINGS 70% % Lifetime History of Depression 60% 50% 40% 30% 20% 10% 0% Women Men ACE Score Source: Felitti, VJ, Anda, RF et al (2010) The population attributable (to ACEs) risk is 54% for depression and 58% for female suicide attempts 16

17 Many of our most intractable public health problems are the result of compensatory behaviours such as smoking, overeating, and alcohol and drug use, which provide partial relief from the emotional problems caused by traumatic childhood experiences. Felitti & Anda, 2010, p. 86.

18 Traumatized children reset their normal level of arousal. Even when no external threats exist, they are in a persistent state of alarm. Bruce Perry

19 TRAUMA AFFECTS social skills and attachment biological systems and medical issues regulation of emotions/impulses dissociation behavioural control cognitive functioning self-concept, shame and guilt future orientation

20 The most significant consequence of early relational trauma is the loss of the ability to regulate the intensity and duration of affects Allan Schore At the core of traumatic stress is a breakdown in the capacity to regulate internal states like fear, anger, and sexual impulses Bessel van der Kolk

21 Children exposed to repeated episodes of overwhelming arousal...may never develop their capacity to self-regulate they may be chronically irritable, angry, unable to manage aggression, impulsive, anxious or depressed. Bloom & Farragher 2011, p.108

22 Number of Alcohol Related Assaults by Region, 2010 to ,600 1,400 1,200 1, ,370 1,225 1,153 1,137 1,009 1, Alice Springs Darwin NT Balance Katherine Tennant Creek Palmerston Nhulunbuy Source: AGD

23 Rate per 100,000 of Alcohol Related Assaults by Region, 2010 to ,000 16,000 15,457 14,000 12,000 10,000 9,957 Tennant Creek Katherine 8,000 Alice Springs Nhulunbuy 6,000 5,262 4,857 NT Balance Darwin 4,000 3,595 4,703 Palmerston 2, ,518 1, Source: AGD

24 Violence in the Northern Territory Aboriginal people in the NT are twice as likely to be hospitalised for assault as are Aboriginal people in the rest of Australia (AIHW) The latest Closing the Gap report revealed that the night patrols which were set up as a first response to violence or potential violence, dealt with over 84,700 incidents in the last 6 month reporting period, or 160,000 incidents p.a. that is in a target area of around 30,000 adults.

25 Violence in the Northern Territory Aboriginal women in the NT make up only 0.3% of all Australian women, but they account for 14% of the hospitalisations for assault The mothers of NT children are 48 times more likely to admitted to hospitalfor reasons of assault than all Australian women In 2009/10, 27non-Indigenous women had assault related admissions to hospital in the NT. In the same period 842 Aboriginal women were admitted Aboriginal women in the NT are 80 times more likely to be hospitalised as a result of assault. (AIHW, National Hospital Morbidity Database, 2011/12)

26 advances in neurobiology suggest that socioeconomic disparities in educational achievement could be reduced more effectively by (focusing on interventions that) prevent, reduce, or mitigate the disruptive effects of toxic stress on the developing brain Shonkoff, 2011, p. 982

27 NT Crime Statistical Regions