Social Work Now, Issue 34, pages 4-10.
The Towards Wellbeing (TWB) programme began with the publication of the best practice guidelines Towards Wellbeing: Responding to the needs of young people Te Kahu o Te Aorangi in 2000. These followed the structure of earlier guidelines for schools. Early integration into Child, Youth and Family social work systems (including training, practice and the operational electronic case record system, CYRAS) followed the same year. However, the 15-fold higher rate of death by suicide among youth in contact with Child, Youth and Family than in the wider community (Smith and Beautrais, 1999; Beautrais, Ellis and Smith, 2001) indicated the need for additional assistance in implementing these guidelines with this particular at-risk population. This led to implementation of the TWB suicide monitoring programme in 2002.
This consult/liaison service included:
- a rapid referral system (by email) which invoked a text message to two mobile phones to notify a clinical adviser to ring back within an hour (usually in the next 10 minutes)
- direct referral to a clinical adviser assigned to support each Child, Youth and Family office and residence
- a review of CYRAS records and other information to identify the young person’s background, and current and possible future factors that might contribute to suicidal and other risk behaviour
- support for the social worker to complete a risk assessment and develop a risk management plan
- assignment of risk level (High critical, High, Moderate, Low) and frequency for the clinical adviser to review the status of the young person with the social worker (weekly, fortnightly and monthly).
Once young people are stable and at low risk, monitoring may be only by review of the social worker’s notes and a three-monthly contact with the social worker. These three monthly follow-ups may alternatively be to another primary caseworker, such as a school counsellor. Later developments included the weekly review of social workers’ electronic case records to identify events or risks requiring the TWB team to contact the social worker. There was also a daily review of all screening tool (CKS) assessments completed the previous day and of those young people with suicide ideation, severe psychological stress or other indicators of risk.
The Wellington School of Medicine operated the programme from 1 September 2001 until 30 June 2005. This survey describes social workers’ views of the service during the final year of that period.