It comes after a new strategy hub was formed with representatives from a range of sectors - including the Central Highlands Integrated Family Violence Committee, the Central Highlands Homelessness Alliance, the Central Highlands Family Services Alliance and the recently formed Central Highlands Care Services Alliance.

CHIFVC's Principal Strategic Advisor, Dr Jess Cadwallader, said the hub brought together the strategic understanding of the homelessness, family service, care and family violence sectors across the region to respond to issues affecting the community a whole, rather than from individual standpoints.

The recent focus on disability comes after a forum was hosted last year, looking at adolescents who use violence in their homes.

With half of these adolescents having a disability of some kind, a need to increase disability competence across the service sector was noted.

As such, a forum called Reshaping the System: Disability Responsive Service Delivery was recently hosted.

Dr Cadwallader has worked in the disability sector for many years and is passionate about improving accessibility to services. She said disability-responsive services were needed as people with disability were over-represented in services; people with disability experience much higher and more frequent and severe forms of violence, especially family violence.

"We see an over-representation of people with disability in out of home care and in prisons - in some of the institutionalised end points of the system," she explained.

Dr Cadwallader said this signified these people had not received the support required earlier in their lives.

"That's an indication that the service system is not providing what people need. People with disability are [service's] clients, they are already probably more than half of the clientele.

"And if the service they need is not provided, then we're not supporting people the way service systems are meant to - to address violence, address homelessness, address family functioning and address the care of children in a safe way."

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Dr Cadwallader said the forum was hosted to emphasise the responsibilities of the service system to offer fully disability responsive service delivery.

"It's about overcoming the segregation around people with disability that has impacted how our service system works.

"Historically there's been a lot of knowledge of disability but only in one corner of the service system, so this is about mainstreaming an understanding of disability and making it a part of every service and every practitioner's toolkit."

The list of disabilities is long - from the more recognisable physical disabilities to the 'invisible' disabilities.

While catering to physical disabilities is becoming more mainstream through access and inclusion plans - installing ramps, accessible toilets and using the national relay service for people with hearing impairments, for example - it can be very different for 'invisible' disabilities, such as psychosocial or neurological conditions.

"The so-called invisible disabilities are really easily misconstrued or misunderstood as sometimes recalcitrance or as resistance on the part of clients," Dr Cadwallader explained.

"So if someone misses an appointment, it counts against them rather than being an indicator that maybe they needed a text message in the morning to remind them because they have ADHD.

"The risk with some of the invisible disabilities is that they might not be recognised and they might not get the response that they need."

Speakers included Jen Hargrave, who is the Senior Policy Officer from Women with Disabilities Victoria. She spoke about the levels and forms of violence experienced by women with disability and the failures of the service system in responding to some people's experiences.

Dr Cadwallader spoke about the social model of disability and why some practitioners incorrectly believe disability is dealt with elsewhere, such as through the National Disability Insurance Scheme (NDIS).

"The physical segregation of people with disability has led to quite a segregated service sector, and we're still dealing with the aftermath of that. We tend to assume that there are special services who deal with people with disability, which isn't, in fact, the case."

The forum also heard from two people with lived experience of accessing the service system and the issues that involved - from the distrust services had of one, almost leading to her child being removed.

The second person spoke of services not knowing how to respond to family violence as they also have health conditions.

"There is an assumption that these things have to be dealt with separately rather than services responding more holistically," Dr Cadwallader said.

"Sometimes I look at hesitations like that from some practitioners and I think 'it's not wrong to be hesitant because we're not very good at it yet'. We do need more practice.

"But ideally there shouldn't be a hesitation - if there is family violence they should be referred to a family violence service and if there's psychological need as well then we should send them to a psychologist."

Dr Cadwallader said this experience highlighted a need for the service sector to work more collaboratively.

"If people have a shared understanding of disability then services could trust that other services would be responsive to disability and they might be less hesitant to refer people."

The forum also heard from Sherree Unwin, an advocate with Grampians Disability Advocacy, about ways to modify practice to increase accessibility for clients.

Dr Cadwallader noted this was important as by increasing accessibility for clients with disability, it creates space for a whole range of others who may be struggling to access a service - such as people from diverse cultural and linguistic backgrounds.

This is particularly important where there is potential for undiagnosed disability. In the context of family violence, this could be acquired brain injury.

Family Services Specialist Disability Practitioners, who have just recently started, also gave the forum a run through of engaging with the NDIS.

During the forum, barriers were also discussed- both in practice and in the system - to providing disability-responsive services.

Dr Cadwallader said disability expertise needed to be included throughout the service system - from the entry point, where many people enter service systems without a diagnosis, to the crisis point.

The lack of disability expertise at intake points can impact a person's whole trajectory through the service system.

"We need to be able to learn how to recognise the signs of disability so they can be offered services in an accessible way, and referred to additional services when required."

One of the biggest issues raised was disability services not being prescribed to the Multi-Agency Risk Assessment and Management framework (MARAM).

Stemming from the Royal Commission into Family Violence, the framework was formed as part of a recommendation to make family violence everyone's business. It means most mainstream services, such as health providers and schools, are equipped to identify the signs of family violence and ensure an individual is referred to a support service, if appropriate.

Not being prescribed to MARAM means the disability service sector is further segregated in the context of family violence, without access to training.

Access to disability services was also highlighted - especially in the Early Childhood Early Intervention space - where there are currently exceptionally long wait lists in the Central Highlands.

"Every phone call is a barrier. Every appointment is a barrier. Every 'just pop into the office' is a barrier with a child with disability", one of the participants with lived experience told the forum.

Another major barrier raised was the risks people with disability were often navigating -meaning many choose not to disclose the information to services in the first place, due to the stigma attached.

For example, if the perpetrator of violence is their carer, a victim survivor may be navigating the risk of being institutionalised as a result of the loss of care or of losing their children.

Other issues raised were unconscious bias, the need to advocate for disability-responsive services to other service providers and difficulties in engaging clients with a disability.

To help practitioners seek secondary consultation, the strategy hub has developed a disability directory on its website with contacts for diagnosis, peak bodies, support groups and training. It is intended that this list will grow.

Dr Cadwallader said the services were really engaged in the forum and recognised there was an issue that needed resources to be addressed.

The strategy hub is now in the process of formulating a report with recommendations for consideration across the sectors at both a practice and systemic level.

Dr Cadwallader said the forum was the beginning of a conversation.

"This is a part of the NDIS transformation of the service system - all services are going to have to step up and shift how they're doing things, and I feel like this is part of that process."

If you or someone you know is in need of crisis support, phone Lifeline 13 11 14. Family violence support is also available via 1800 RESPECT. The Orange Door in Central Highlands can be contacted on 1800 219 819 from 9am to 5pm Monday to Friday - except public holidays. For more information, visit orangedoor.vic.gov.au.

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