• Home
  • Research
  • Community Health
  • EIT study evaluates national pilot programme growing skills of health professionals working with vulnerable children

EIT study evaluates national pilot programme growing skills of health professionals working with vulnerable children

Associate Professor Rachael Walker runs the patient-centred research project that examines services from the patients’ perspective, in this case kidney dialysis in community houses.

EIT study evaluates national pilot programme growing skills of health professionals working with vulnerable children

A comprehensive three-year study, led by EIT’s two research professors, has evaluated a national pilot programme growing the skills of health professionals who work with vulnerable children and their families in Hawke’s Bay.

The research into the Ngātahi project ended in June last year and assessed how the project established a sustainable system for practitioners to identify the additional skills they believe they need, developed training programmes to address these needs and built relationships between workers in different organisations.

The Hawke’s Bay District Health Board (HBDHB) awarded EIT the contract to assess the impact of Ngātahi for the 500 professionals who work with vulnerable children and their families. The third and final Ngātahi report was published in June 2020.

EIT’s research team was led by Research Professors Kay Morris Matthews and David Tipene-Leach. Other members of the multi-disciplinary team were health researcher Dr Sally Abel; Dr Anne Hiha from the School of Education and Social Science; Chris Malcolm, a Mental Health Lecturer in the School of Health Science; social work programme coordinator Charlotte Chisnell and social work lecturer Karlin Austin, both of the School of Education and Social Science; and EIT researcher Pippa McKelvie-Sebileau. Kay and David both also sat on the Ngātahi Board of Governance as critical friends.

The sponsor of Ngātahi was former Children’s Commissioner and local paediatrician, Dr Russell Wills, while Dr Bernice Gabriel, senior psychologist, was the project manager. Both are from the HBDHB.

Ngātahi came about in 2017 after workers in health, education and social services in Hawke’s Bay reported increasing numbers of children with learning and behaviour issues.

These children often live with parents in tamariki Māori were over-represented among these referrals.

“There was a strong view among many workers that they needed additional skills to adequately assess and manage these issues and that there were few evidence-based interventions available,” says Kay.

“There was also concern across the sector that the government organisations, mainstream non-government organisations (NGOs) and kaupapa Māori NGOs involved worked in silos. Families/whānau and children were often confused about the numbers of services involved and either disengaged or fell between the gaps.”

Ngātahi began by first developing a partnership with Māori via relationships with the Hawke’s Bay DHB’s Māori Relationship Board and mana whenua, Ngāti Kahungunu Iwi Incorporated. The DHB Māori Health team helped Ngātahi develop a Māori conceptual framework which came to be known as Ngā Pou. These Pou became a basis for the development of wānanga which were written and delivered together with experts in Ngāti Kahungunu tikanga.

Ngātahi, which means together, had three broad objectives when it began three years ago. These were: to establish a sustainable system for practitioners to identify the additional competencies they believe they need; to develop training programmes to address these needs, both clinical and cultural competency; and to foster relationships between practitioners in different organisations that would facilitate intersectoral collaboration when working with complex families/whānau.

The first report in January 2018, of the three-year project called Towards Better Outcomes for Vulnerable Children and their Families: Ngātahi Working as One focused on the first phase of Ngātahi, that is, the core competency mapping process and development of specific skills training. Three priority training areas identified – Mental Health and Addictions, Trauma Informed Practice, and Engaging Effectively with Māori. The learning model developed for the planned training included three parts: online learning, skills-based wānanga, and ongoing small group ‘learning circles’ or wānanga ita which were established to embed learning and provide peer coaching.

This first report included an early evaluation of training provided for Child, Adolescent and Family Service (CAFS) practitioners from the HBDHB around Mental Health (but not Addictions) some of the behavioural therapies used in practice, and a cultural competency component for CAFS practitioners at HBDHB.

The second report of the evaluation looked at the planning and delivery of Mental Health training to the wider workforce, including a follow-up on progress with the staff of the CAFS service who went through the 2017 Mental Health training.

A Self-Care in Trauma Informed Organisations wānanga was also developed as a direct result of the first-year evaluation findings which highlighted the fact that practitioners were stressed and vicariously traumatised. The Trauma Informed Practice wānanga training was initiated much later in the pilot but cut short by the COVID-19 lockdown. The self-care wānanga have been very popular and the evaluation of this was presented in the third report alongside questions examining what did and did not work well in the wānanga training format developed.

“A rich data base for analysis was produced because of the calibre and sheer honesty of the responses from the practitioners. They highlighted the dilemmas and stresses placed on the frontline workers across their different professional and occupational groups.”

“I was impressed by how committed practitioners are to helping the vulnerable children they see. Even though many were stressed, burnt out and dealing with distressing situations, they remain determined to make a difference for these children,” says Kay.

She says it is encouraging that both practitioners and managers have unanimously endorsed the existing Ngātahi training, as well as welcoming future training.

“Many managers have also reported the positive steps made during the three years to increase communication between organisations. However, all reported that there is still work to be done, including in and around cultural competency.”

“Overall, the goal is to ensure that our region’s vulnerable children are seen more quickly, referred appropriately, assessed more comprehensively, and provided with relevant and evidence-based therapies/solutions.”

Kay believes the Ngātahi Project has achieved a lot and can make further strides in future.

“We have enough experts on the ground in Hawke’s Bay running these very sophisticated wānanga, which practitioners believe are making a difference.”

“With funding now in place, Ngātahi can go from strength to strength. The focus will be on more training in areas like addictions and care and protection. More organisations will also be invited to join the project, which will add more diverse voices and perspectives from across the sector.”

Kay says there has been interest from other District Health Boards to implement the project in their areas and she was hoping they would.

“We have to do all we can because the welfare of our vulnerable children is at stake. We must do all we can.”