Professional Documents
Culture Documents
He Tu Rangatira Te Tuhauora
www.kepaantricassociates.co.nz
Tim Antric
Contents
Abstract 2
Acknowledgements 3
Introduction 3
The Accident Compensation Corporation 3
Family Violence in Aotearoa New Zealand 5
The Cost of Family Violence to the Accident Compensation Corporation 9
Health Promotion 10
Injury Prevention 11
Family Violence Prevention 13
Primary Prevention 13
Secondary Prevention 14
Tertiary Prevention 15
Prevention of Family Violence 15
Parenting Programmes 16
Universal Home Visits 16
Social Marketing 17
Universal Screening 19
Education of Children and Young People 19
Community Development and Action 21
Working with Witnesses of Family Violence 23
Working with adult female victims 25
Working with Perpetrators 26
Government Legislation and Strategy 27
Health promotion: An approach to the prevention of family violence. 28
The Role of ACC in family violence prevention 30
Conclusion 34
References 36
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Abstract
Family violence has been found to affect families from all cultures, backgrounds
care and rehabilitation costs of all New Zealanders injured within the confines of
Aotearoa New Zealand. The huge cost of family violence to the Corporation
requires ACC to act to reduce the impact of family violence on its claim costs.
secondary and tertiary levels, ACC will impact its own costs and thus the levies
to its funders while contributing to making Aotearoa New Zealand a safe place for
made.
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Acknowle dgement s
the members of the Te Rito Advisory Group for their support and advice in
Introduction
This paper will examine the role of the Accident Compensation Corporation in
reducing the incidence and severity of family violence in Aotearoa New Zealand.
It will also provide an overview of family violence and effective health promotion
and injury prevention models to reduce the effect of family violence on society
I will begin by introducing the New Zealand accident compensation scheme and
providing an overview of family violence and its cost to the Corporation. I will
then look at the most common approaches to health promotion and injury
initiatives that have taken place both locally and internationally to prevent family
violence, showing how these fit within a health promotion framework and finally,
Whara (ACC) was established on 1st April 1974 to administer a no-fault coverage
against injury scheme for every New Zealander (ACC 2004). The accident
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the Accident Compensation Bill into law. The original system had three parts:
• Compensation for work injuries, funded through levies paid by workers and
their employers;
motor vehicles;
Government.
There have been many changes in the scope and structure of the Accident
Rehabilitation and Compensation Act 2001 (IPRC). The IPRC is essentially a set
scheme, how the scheme is funded and how much can be paid out to claimants.
A major change brought about by the introduction of the IPRC has been an
increased focus on injury prevention. Section three of the Act provides the
Corporation with the responsibility “to enhance the public good and reinforce the
minimising both the overall incidence of injury in the community, and the impact
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(IPRC 2001). Section 263 of the IPRC requires that the Corporation undertake
These include:
Development 2002);
• Opportunity for All New Zealanders (Office of the Minister for Social
Development 2004).
Whilst not a major stakeholder in the area of assault within these strategies, the
Corporation as a result of its interest in the prevention of intentional injury has the
social and economic costs for our society. Family violence has been found to
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compromises the safety of children, adults and elders and its effects are broad
not new, however identifying effective best practice can be problematic. A broad
range of controlling behaviours falls under the banner of family violence. These
occur in all close personal relationships, wherever individuals are part of a family
or fulfilling the role of family. Common forms of violence within the family include:
partners);
• Elder abuse or neglect (abuse and neglect of people over the age of 65 by a
Zealand between $1.187 billion and $5.302 billion per year (Snively 1994). It
further contributes to the continuation of the cycle of abuse within families and in
most severe and lethal cases of family violence are predominantly men; their
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35 percent of women are hit or forced to have sex by their partners at least once
in their lifetime, while seven percent of men report experiencing this type of
abuse. A 1995 study revealed that one in five New Zealand men admitted
assaulting their partners in the previous year (Leibrich, Paulin & Ransom 1995).
Zealand Police Statistics for 1996/97 operational year, men were the offenders in
Zealand studies found that 35 percent of men reported physically assaulting their
partners (Leibrich, Paulin & Ransom 1995) and 33 percent of women reported
suggest that between four and ten percent of New Zealand children experience
Between 1996 and 1997, 38,000 children were present during the 30,340 family
violence incidents attended by New Zealand Police; 28,621 were under 10 years
1
Whilst the term Māori is more commonly used to refer to the indigenous peoples of Aotearoa New Zealand, the author
uses the term Tangata Whenua as this is a term used by these peoples as opposed to the term Māori, introduced by the
European colonisers of this land.
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old, and 9,844 were aged between 10 and 16 years (New Zealand Police 1997).
From interviews with children, researchers found that almost all can describe
detailed accounts of violent behaviour that their mother or father never realised
In the year to June 2000, the Department of Child, Youth & Family Services
Ministry of Social Development) 2001). Further, in the four years to 2002, over
1,600 children under the age of 10 years were sexually abused. Given the
nature of this issue, the number of child victims (as with women) is considered
grossly underrepresented.
psychological and sexual abuse, and children who are subject to one form of
abuse are significantly more likely to suffer other forms of abuse (Briere & Runtz
1990).
There are significant overlaps between male violence against female partners
and child abuse and neglect. A comprehensive review of studies in this area
abuse is found, the other type of abuse occurs also (Edelson 1999). The
partner abuse.
Most research estimates that between two and five percent of the older
population are victims of elder abuse. In Aotearoa New Zealand, based on the
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1996 census, this means there could be between 8,453 and 21,133 older New
Zealanders suffering from some form of abuse and neglect. Most elder abuse
victims are aged 70 to 84 years, with psychological abuse considered the most
For the purposes of this paper, family violence will be assumed to include
intimate partner abuse and child abuse or neglect. The prevention of parental,
elder and sibling abuse are beyond the scope of this discussion, primarily due to
the lack of clear evidence that these present significant cost to the Accident
Compensation Corporation. It should also be noted that these three areas are
not currently being prioritised within either Opportunity for All New Zealanders or
a possible 6,660 cases at a cost of over NZ$21 million (Stephenson, Trotter &
female” (i.e., intimate partner abuse) is the most common type of violent crime
2
Public hospital acute services (i.e., emergency departments) within Aotearoa New Zealand are funded by a bulk
payment from ACC to the New Zealand Government. The Ministry of Health is then funded by the Crown to purchase
these services from the District Health Boards on behalf of ACC.
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recorded by New Zealand Police and thus the most common reported assault.
We can therefore assume that family violence is the most common form of
assault, with intimate partner abuse alone accounting for half the cost of assault
to the Corporation.
The Ottawa Charter for Health Promotion defines health promotion as “the
process of enabling people to increase control over, and to improve their health”
(World Health Organization 1986). The three strategies for health promotion
identified in the charter are advocacy, enabling and mediating, these are
1998) as “advocacy for health to create the essential conditions for health...
enabling all people to achieve their full health potential; and mediating between
The three strategies of health promotion are supported by five key areas for
action:
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There are many other models for health promotion and a range of theories to
support the different facets of this emerging discipline however, with the
(Lane & Gardiner 2003), the Ottawa Charter for Health Promotion is sufficient to
Under the IPRC, the Corporation clearly has a role to play in reducing the level of
family violence within society and thus reducing its own costs. Section 263 of the
IPRC recognizes that in fulfilling its primary function to reduce personal injury, the
mostly in the areas of sport, traffic, workplace and falls. Within these areas, the
prevention makes use of the models of health promotion, specific models have
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also been developed. The Spectrum of Prevention (Cohen & Swift 1999)
programmes.
Strengthening Individual Knowledge and Skills Enhancing an individual’s capability of preventing injury or
others
Fostering Coalitions and Networks Bringing together groups and individuals for broader
Influencing Policy and Legislation Developing strategies to change laws and policies to
influence outcomes
prevention reduces the risk to those in high risk groups whilst tertiary prevention
subset of health promotion, this paper will consider primary, secondary and
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tertiary injury prevention activities as they fit into the framework for health
promotion action proposed by the Ottawa Charter for Health Promotion (World
Health Organization 1986). The various activities will be considered as they fit
Given the limited access to University facilities provided by the author’s remote
location, the internet has been utilized to identify and obtain the literature relating
www.google.com and the key words “family violence” and “primary prevention”,
“secondary prevention” or “tertiary prevention”. The author has also made use of
his substantial connections within the family violence sector in Aotearoa New
Primary Prevention
also be noted that whilst much research has been done on the prevalence of
family violence within Aotearoa New Zealand and elsewhere, little sound
research into the most effective practices is available (Bethea 1999, Family
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Secondary Prevention
occurring. This will include child witnesses of intimate partner violence, siblings
• Addressing the needs of the perpetrator to ensure they do not widen the
chance of families where either child abuse or partner abuse is found, also
• Working with child and adult witnesses of family violence to develop safety
behaviours and to break the cycle of violence, particularly given the strong
1980);
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• Providing key workers with the skills to recognise and respond appropriately
Tertiary Prevention
There are a range of interventions offered within Aotearoa New Zealand to assist
protect women and children from abuse by family members (i.e., Protection
Orders and specific offences relating to family violence) and programmes such
as Strategies with Kids, Information for Parents (SKIP), the Ministry of Social
disciplining children along with strategies to raise happy and healthy children.
It is recognised that many initiatives and practices to address family violence will
cross all three levels of injury prevention, this was evidenced most recently in the
grass root projects to address family violence failed due to linkages between the
There are a wide range of strategies and programmes operating within Aotearoa
shall consider those which have been evaluated here. It should be noted that
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many potentially effective programme running throughout the world have not
Parenting Programmes
most programmes within Aotearoa New Zealand operate from a parenting skills
model as they vary considerably in scope, some are aimed at all parents, some
at high risk parents and some at parents who have already abused their children.
this was the only programme identified that had been evaluated.
The programme reported having a strong theoretical and research base, clear
methods for using learning to inform practice, being specific about parenting
skills and making use of a wide variety of referral routes. Weaknesses of the
programme included a failure to engage with families in greatest need for the
Bethea (1999) reports that of the range of supports offered to parents, including
long term home visitation, short term home visitation, early and extended
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classes, only long-term visitation has been found to be effective in reducing the
between parents and children and reduced incidences of child abuse. However
the high costs associated with a universal home visiting programme have
Social Marketing
achieve social change (i.e., to influence social and health behaviours and
attitudes). It is intended to influence how people think and behave (Nutbeam &
Harris 1999); examples of social marketing materials include television and radio
throughout the world, examples include the Family Violence Prevention Fund
There’s No Excuse for Domestic Violence, (Fullwood 2002), Freedom From Fear
(Donovan, Francas, Paterson & Zapelli 2000), Aktiv gegen Männergewalt / Active
from the premise that it is necessary to change social norms that allow family
violence to exist. A range of media have been utilised, including posters, print
and broadcast media, information pamphlets, CD ROMs, large scale events and
the internet. The target groups for the campaigns have included the general
public (Fullwood 2002, Women Against Violence Europe), adult males (both
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& Zapelli 2000, Reid Howie Associates Ltd 2001), the use of research in
2000), creating critical discussion around the issue of family violence (Reid
Howie Associates Ltd 2001, Women Against Violence Europe) and consistent
2000).
communities, peer groups and families (Women Against Violence Europe). The
knowledge however few gains have been identified relating to long term
awareness of services and thus referrals (Hall & Stannard 1997), a useful result
but often not the purpose of these campaigns. Mass media campaigns are of
Europe).
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Universal Screening
Universal screening of families for family violence has been common in many
countries for some years now, whilst it is only now being introduced to Aotearoa
New Zealand thanks to the recently developed Ministry of Health Family Violence
(Edelson 2000) have shown that universal screening does increase the
those who are not exposed to family violence and the lack of clear evidence of
violence have occurred. Many programmes have been evaluated and results
general. However, it must be noted that the longest follow-up period for any
The lack of any long term follow up of education programmes noted above
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child abuse, young people’s intimate relationships and family violence as a whole
are being delivered in many territories throughout the world however the lack of
long term outcome evaluations makes it impossible to identify the factors that
create successful projects. The projects discussed here report some gains and
attempt to identify factors that contribute to their success however; the short-term
The school activities contained within the Aktiv gegen Männergewalt (Women
initiated ongoing activities within schools however, the campaign did note the
support and training was also reported by the Zero Tolerance Young Person’s
pertinent issues amongst young people, including the nature and extent of family
level and quality of planning work and the support available to staff delivering the
project.
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abuse of themselves or their peers, with parents reporting that students who had
teachers around the more sensitive issues, parallel information sessions for
their capacity to address the issues that they identify. Core components of
action to tackle an identified issue (Antric 2005). Both are valid approaches to
addressing the prevention of family violence and have been utilised in many
communities.
The Aotearoa New Zealand Sure Start programme is based on a British model
aimed at “improving health and emotional development for young children” (Sure
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outreach and home-visiting, support services for families and children, quality
childcare and children’s facilities, community healthcare, and support for children
with special needs, it can more accurately be called community action. Given
that local governance bodies, including parents and community leaders, exist to
the conditions that support family violence and making services accountable to
ensure community ownership at the most local level (Maciak, Guzman, Santiago,
area (Sidey 2001, Ridge & McLeod 1997). First and foremost any definition of
violence must be negotiated locally and must include a local definition of the
problem, including race, gender, ability and sexuality issues. Preventative action
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psychological lives from the moment of birth and providing children with the
opportunity to talk about any negative experiences will support their present and
future health (Kelly, Anderson & Dawson 2003). Any intervention undertaken
family violence will deal with both the short term needs of the children and
breaking the pattern of aggressive behaviour associated with the cycle of abuse
Many programmes to address the needs of child witnesses of family violence are
Justice 2004A), they are provided for the general population and for Tangata
evaluated (Ministry of Justice 2002B), the evaluations found that the programmes
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express their feelings about family violence and develop strategies to protect
themselves.
The uptake of Protection Orders has declined in recent years (Jacobson 2005)
and whilst the Ministries of Justice and Women’s Affairs are undertaking
research regarding this, any results are not yet available. Alongside the low
uptake of Protection Orders has been low uptake of Ministry of Justice approved
programmes (Jacobson 2005). This results from both the low use of Protection
benefits of Protection Orders and the available services to families has been
Violence Centre (Bennett, Coggan, Fill & Lee 2004). Evaluation of this project
determine whether this and similar projects have a significant effect on the
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victim is male, gay, bisexual or has other special needs, individual programmes
violence” (Maxwell, Anderson & Olsen 2001). Maxwell et al found that the
reporting that they had learned how to keep themselves safe, 92 percent
reporting that they had learnt how to keep their children safe and 91 percent
reporting that they had a safety plan in place for themselves and their children.
programme had actively contributed to them feeling safer and being more able to
The study by Maxwell, Anderson and Olsen (2001) attempted to identify best
practice, although it should be noted that this was not done by comparing the
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programmes included not being able to meet the broader needs of participants
(i.e, if a woman did not have secure accommodation for herself and her family
programme via the Family Court was considered inadequate and further support
in accessing the programme was required, and accessing programmes was also
one facet of the array of legal responses to family violence. The primary
the criminal justice sector, and significant improvement in their wellbeing. The
partners of the men also reported a reduction in the frequency and nature of
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behaviour was reported. It should be noted that behaviour change was only
and even here there was some decline in participants’ sense of wellbeing and
further follow up may find that any behaviour change was not maintained
a failure to meet the cultural needs of men from backgrounds other than Tangata
using physical violence. This compares to a success rate of around half reported
overseas (Gondolf 1998 cited in Ministry of Justice 2004D) however given that
Aotearoa New Zealand studies have not been undertaken over a longer period it
may be that the rate of non-violence fall over the longer term.
The legislation relating to family violence within Aotearoa New Zealand is largely
encompassed within the Domestic Violence Act 1995 (DVA) and the Children,
Young Persons, and Their Families Act 1989 (CYPFA). These acts provide for
the safety of victims of family violence, support to at-risk families and the
3
New Zealand European
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weakness of these Acts is their failure to provide for the mandatory reporting of
family violence.
The two key government strategies relating to family violence are Te Rito: New
Zealand Injury Prevention Strategy and Opportunity for All New Zealanders. The
prevention while the latter identifies violence within families as one of five priority
areas for government. Te Rito identifies the key areas for action in preventing
family violence whilst Opportunity for All represents the largest ever commitment
from the New Zealand Government towards the eradication of family violence.
As noted earlier, family violence is also addressed through the New Zealand
• Parenting programmes;
• Social marketing;
• Universal screening;
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There are many other areas which will impact on the prevalence of family
violence in our society and reductions in the frequency and intensity of that
violence however, these are either too broad to consider in a targeted approach
or lie too far beyond the scope of ACC to be considered in this paper. The
violence fit within the health promotion framework provided by the Ottawa
Charter.
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Clearly all the family violence prevention activities outlined in this paper fit within
the health promotion framework provided by the Ottawa Charter. Family violence
prevention is most clearly health promotion but what is the role of the Accident
estimates place the cost of family violence to ACC as approximately NZ$7 million
Research Unit, this may be as high three times this figure (Stephenson, Trotter &
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victimisation of women and children and increasing the safety of at-risk families,
community and societal level, and supporting the development of a violence free
Services for victims and perpetrators of family violence in Aotearoa New Zealand
are already provided by the Department of Child, Youth and Family, Ministry of
respondents and their families), services for at-risk children and education
violence has been low. This may be due to the lack of awareness of these
to explore this. Given this situation, ACC should explore the means by which the
Corporation can support families in crisis to take out Protection Orders, access
4
Extended family, the basic unit of indigenous society within Aotearoa.
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of the effects of children witnessing violence. This will provide a cost effective
means of increasing the support for families given that Ministry of Justice funding
place. Thus the Corporation can ensure that child witnesses and adult victims of
family violence are better supported and that the cycle of violence is broken.
ACC does not involve itself in home visits or in working with families however, as
a provider of rehabilitation and care services for people with injuries it does have
significant contact with up to 1.6 million New Zealanders each year (ACC 2004)
through the Corporation’s staff and external contractors. ACC should therefore
develop policies and procedures to ensure that the claimants it, and its agents,
at risk of, family violence. The Corporation should also explore funding major
New Zealand Plunket Society, Barnados New Zealand, etc.) to undertake similar
programmes to break the cycle of violence in families, ACC will see a reduction
in the severity and incidence of family violence. However, these strategies need
relating to violence.
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territories throughout the world, including Aotearoa New Zealand. For these to
be effective they need to be sustained over a long period of time and to combine
with local awareness raising and community action. The Corporation should
local social marketing along with community action. It is recommended that ACC
work with the lead stakeholders in the area to develop messages and social
Social marketing and community action will begin to make changes in the diverse
through work with children and young people. Changing the attitudes and
expectations of the young whilst working to target the whole population will
recommended that ACC support the further expansion of the New Zealand Police
centres, primary and intermediate schools and colleges. This will ensure that the
same messages are received throughout a child’s scholastic career and that the
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ACC must also maintain its involvement in the various national strategies relating
injury prevention staff in Aotearoa New Zealand and has substantial opportunity
to reduce its costs relating to family violence through supporting the New
Zealand Government to create a society in which everyone can live free from
violence.
Conclusion
ACC has a role to play in the reduction of the severity and incidence of family
supporting the key Government agencies addressing family violence and its
of Child, Youth and Family Services, Ministry of Justice and New Zealand Police)
associated with family violence related assault in a cost effective manner, the
available and as such must seek avenues to add value. The recommendations
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Through supporting the activities outlined above and aligning its strategies with
the key stakeholders in the sector, ACC can fulfil its obligations under the IPRC
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