Callers to the national sexual assault and domestic violence hotline will no longer have guaranteed direct access to experienced trauma counsellors from July 1.
In a dramatic change to the six-year old service, people who ring 1800 RESPECT will be advised by a triage service, employing operators who will judge whether callers should be directed to an information website, a trauma counsellor or state-based family violence services, already overloaded with demand.
The move comes in an attempt to combat the delay in calls being answered by 1800 RESPECT and is another in a suite of restructurings by the Coalition to hotlines for health services.
Medibank Health Solutions has always had the contract for providing the hotline but in the past was required to subcontract to Rape and Domestic Violence Services Australia (R&DVSA). In an attempt to rein in costs, while at the same time improve answer times, MHS has now formed what it describes as a "short-term Implementation clinical advisory group". The deadline for responding to an invitation to join that group was last Friday and no meeting has yet taken place, despite changes to the service slated for July.
The Department of Social Services engaged KPMG to do a review of the existing 1800 RESPECT business model and, in documents seen by Fairfax Media, KPMG offered three options for the hotline: increased funding for the existing operating model; a social worker/first responder triage function; and a trauma-specialist triage function.
In the presentation from KPMG, each of these options has strengths and weaknesses yet only one – the option to be adopted by MHS – mentions specific risks to callers with the recognition that those requiring trauma-specialist services of R&DVSA "will have to navigate an additional layer of service".
Zoe Krupka, a psychotherapist with over 15 years experience, fears the triage model.
"By the time somebody gets to the point of ringing a hotline service they are in serious crisis. They need someone with the skills to provide counselling," she said.
Ms Krupka, who has provided counselling for a range of hotlines, said callers had huge complexities of problems. She has accessed the hotline in a professional capacity but has also had patients who used the service and found it beneficial.
"Sometimes that takes an hour and, statistics-wise, that doesn't look good. Once you triage, you answer more calls, but where do you go from there?" she said.
The draft terms of reference for the group claim to "inform and support the development of a well-prepared and sustainable clinical framework and delivery model for the 1800 RESPECT First Response Function", but none of its members is from the1800 RESPECT hotline service or its parent body, R&DVSA.
Those employed as counsellors for 1800 RESPECT are either psychologists or social workers with a minimum three years' of counselling experience and then asked to undertake 10 days of trauma specialisation training. The advertisements for those working in the new service are seeking applicants with three-year tertiary qualifications and two years of counselling experience and will offer an eight-day trauma specialisation.
A small percentage of those ringing 1800 RESPECT are seeking information. In the most recent annual report for the service to the Department of Social Security, 1800 RESPECT logged almost 30,000 calls. Just 2628 were non-counselling calls and, of those, 2163 were what is described as "hang up" – where the caller hangs up immediately the call is answered.
KPMG examined the business model of the phone line because callers were abandoning their attempts to seek help at the rate of one in two, but changes to the operation of the hotline saw that number reduced to one in five over the past year.
1800 RESPECT is undergoing a review of its entire operations.
A spokesperson for the Minister for Social Services, Christian Porter, said the new model for 1800 RESPECT is expected to begin in August.
"MHS will be provided with $5m to implement the new model that will dramatically increase the number of calls answered," the spokesperson said.
"The minister consulted with, and took into consideration the views of, 1800RESPECT and also met with Karen Willis to hear first-hand her proposals, which were considered in developing the new model."