Historical Out-of-home Child Care Leavers and Mental Health Needs

Australian social workers are encountering an ageing population, which includes Forgotten Australians to whom the Federal Government apologised and who it identified in 2009 as a special needs group under the Aged Care Act (Rudd, 2009). First acknowledged by a Senate Community Affairs Reference Committee (SCARC) in 2004, Forgotten Australians—many of whom refer to themselves as Now Remembered Australians, homies, or wardies—have become the subject of several research studies exploring their needs as they age (see University of New South Wales, 2016). Forgotten Australians are predominantly Australian-born, non-Indigenous adults who experienced different forms of out-of-home care as children, including foster homes and institutional regimes, prior to 1974.

I was one of these children, having been surrendered with my five sisters to a Catholic orphanage in 1965 as a result of dysfunctional parenting. At that time, it was not considered necessary to inform children why we had been removed from our home and placed in institutional care. I thought our parents no longer wanted us and just gave us away to the nuns. I spent nine years from age 10 to 19 in care and during that time some of the things I did not learn to do were how to communicate; how to find somewhere to live; how to get a job; how to live a basic life out in society. What I did learn was how to march and how to fold my clothes. Discipline was more important. Having control over these children was more important than teaching them the skills to have a normal life. I ended up in punitive care because I kept running away.

These forms of historical out-of-home child care have again become topical in the public discourse, having largely been fuelled by the media’s coverage of the Royal Commission into Institutional Responses to Child Sexual Abuse. I say “again” because there have been five state reports exploring the experiences of historical care leavers in Australia since the Queensland Forde Inquiry in 1999. However, the majority of the recommendations resulting from these inquiries, although often agreed to in principle by state and federal governments, have not been implemented. The overwhelming majority of testimonies provided to the inquiries were from adults who experienced extreme trauma and neglect as children while in state-sponsored care.

For many, these negative experiences were only the beginning of their life challenges. These Forgotten Australians have a higher than average representation in unemployment, poverty, addictions, domestic violence, and incarceration statistics. They also have many health issues that accompany the experience of such problems. These issues include physical health, as well as impaired psychological and emotional wellbeing. When I left the institution at the age of 19 I had no sense of how to conduct myself. I felt that because I was so different, people would make fun of me. I was only ever able to find short-term employment. I actually became a hermit. I went out and lived in the bush by myself, with myself, for myself, for 10 years. I neglected myself very deeply and got sick out there. I was so sick that I was forced to come back and engage with society. I was 45 when I walked out of the bush. One of the things I realised was that if I was forced to live in society I somehow had to reconcile myself with society. I completed a tertiary preparation program, and then a social science honours degree. Recently I gained my PhD.

Matters relating to mental health have been highlighted in my recent study on Forgotten Australians. Of the 21 participants interviewed for my PhD research, 20 had at some time sought professional counselling (Smith, 2015, p. 210). It was observed that the majority were exploring and asking questions about their childhoods in an attempt to understand their out-of-home care experiences. This process of reflective exploration reactivated past traumas, resulting in a desire to engage a professional counsellor. This has effectively increased the demand for the provision of specialised professional counselling services across all states and territories of Australia. Conversely, one of the challenges for Forgotten Australians is in accessing professional counselling that is sensitive to their specific requirements.

In partial acknowledgment of this, the Federal Government has funded the creation and implementation of a national website as a central point of information dissemination to assist Forgotten Australians (www.findandconnect.gov.au/). Find and Connect is a central online portal for historical care leavers that provides Forgotten Australians with easy access to specialised support services and advocates. The implementation of this online information site has seen an increase in people being directed to service providers such as Wattle Place in New South Wales (NSW). One of the challenges for such providers is their ability to adequately fund the increasing volume of requests for professional services such as counselling, due to ongoing funding cuts by consecutive NSW state coalition governments. Hence, the ability of these providers to provide the ongoing long-term psychological counselling required by Forgotten Australians is increasingly difficult. While it must be acknowledged that some state governments, such as the South Australian government, are more willing to support the psychological needs of historical care leavers, others such as NSW are less inclined to do so. Because of these inconsistencies and a lack of support by some governments, a nationally coordinated approach in funding the needs of Forgotten Australians is needed. This would contribute to establishing equity in addressing issues such as the psychological needs of historical out-of-home child care leavers. This approach should be in the form of a national health policy similar to the Federal Government’s Access to Allied Psychological Services (ATAPS; Australian Government, 2015). Importantly, any new policy directed at improving the psychological wellbeing of Forgotten Australians should not include the limitations on access contained within the current ATAPS policy.

Social workers have in the past played and continue to play an important role in assisting out-of-home care leavers in transitioning from extreme disadvantage including homelessness, social disconnection, and family isolation to a position where opportunity for change exists. For example, as indicated above, many Forgotten Australians experience homelessness, which can also be a result of mental health and social trust issues for many in this population. Thus, the establishment of rapport and trust are important if a Forgotten Australian is to begin the transition from being invisible and disadvantaged to acquiring agency and voice. Social workers are often in a position to provide the necessary continuity of a professional relationship required to initiate such rapport building. They can be central to the process of engagement and social inclusion for Forgotten Australians for a number of reasons. One of these includes the ability of a social worker to be a part of the process of walking the person through the acquisition of their needs. These can include exploring essential “social basics” such as accommodation and the establishment of an “official” identity. Because of their disengagement from mainstream social life, many Forgotten Australians have deep trepidation and experience cognitive dissonance when faced with having to approach an agency or make the necessary enquiries and appointments for themselves.

Because of the possibilities of Forgotten Australians experiencing relived trauma as they age, it would be an advantage if social workers had some knowledge of the specific sensitivities of this population. For example, in an attempt to establish some footing in a community, Forgotten Australians may require advocacy and assistance in untangling what to them can seem to be an insurmountable bureaucratic system. Although they may be a recipient of some form of welfare payment, they may still be required to re-establish their “official” identity to the satisfaction of housing and accommodation agencies or other service providers. The process of “official” identity establishment can be arduous and is sometimes a retraumatising process. This can be because a Forgotten Australian can revisit past experiences such as family dysfunction, domestic violence, sexual or physical abuse, or the death of a family member, which may have been the catalyst for their out-of-home experience originally. A common outcome of out-of-home care experience is resentment toward authority and “official process”. As such, it could be beneficial if a social worker could identify a person presenting and requesting assistance as a historical care leaver early in the therapeutic relationship. This could also assist in minimising the possibility of retraumatisation.

As Forgotten Australians, we are not that different. We have aspirations, we have goals, and we have rights. Our rights were abused as children. We want that recognised and we want a national redress scheme because we found ourselves with inabilities as a result of the abuse we experienced in these institutions. We need assistance to help us prepare for our senior years, and social workers can play a key role in providing that assistance and advocating for our rights.