Emergency Services Outreach Guidelines Australian Red Cross Emergency Services Outreach Guidelines Australian Red Cross

Published Jan 2015

© Australian Red Cross

This document may not be used, copied, reproduced or disseminated by or to any other person except with the express written permission of Australian Red Cross, which may be given subject to conditions. Contents

Introduction 2 Referals 9 Family Violence 14 Self Harm 21 These guidelines are A referral happens when Family violence includes The most common purpose designed for use by Red a resident requests Red Cross violence or abuse against of self-harm is to try to reduce Cross Emergency Services 3 to make contact with another 6 a partner, adult child, 9 difficult emotions such as people to guide and assist agency or service provider sibling or other close relative anxiety, tension and/or to cope on their behalf. The residents or someone within a shared with an interpersonal difficulty details are taken and passed household or domestic when other strategies don’t on to the relevant agency relationship. seem to be working. Safety 5 by Red Cross. The safety and well-being of Red Cross people always 1 comes first when conducting Illegal Activity 17 Suicide 22 outreach. Under no Entering a Property 10 If a Red Cross person Suicidal behaviour results from circumstances should Red In most cases during Outreach, witnesses illegal activity a complex range of personal, Cross people compromise Red Cross arrives at properties 7 at a home or property whilst 10 social and situational issues their own safety for the sake 4 unannounced and without conducting Outreach (other affecting a person. Often of visiting residents. an invitation from the resident. than child abuse), they are it may appear that a particular not obliged to report it. incident has ‘caused’ the suicide, however, when considered more closely there Privacy, Information 6 Child Protection 13 is usually a combination of Gathering Aggressive Behaviour 18 Australian Red Cross is issues or a pattern of earlier During Outreach, Red Cross a child safe organisation. In conducting Outreach Red difficulties that are present. 2 people must explain to each 5 All Red Cross people involved Cross people may come across resident the purpose of the in Outreach activities must 8 people that are very distressed Outreach visit. have signed the updated Red or upset, or who become Cross Child Protection Policy distressed or upset whilst and be provided with a copy talking. This can be a difficult of the Red Cross Child situation to manage. Protection Handbook. Introduction

These guidelines are designed for use by Red Cross The aim of Outreach is to provide Psychological Emergency Services people to guide and assist them First Aid (PFA) to individuals, families and households when conducting Outreach. They were developed in affected by emergencies. Whilst each of the consultation with all state Emergency Services teams, situations outlined in these guidelines can be difficult as well as the National Preparedness, Response or challenging, it is important to remember that and Recovery Coordinators and staff. Sections 9 Outreach is a rewarding experience and that and 10 ‘Self harm’ and ‘Suicide’ were developed difficult or challenging situations are uncommon. in collaboration with the Australian Psychological It is important that Red Cross people are aware of what Society. All Red Cross people should familiarise support is available to them and practise self-care. themselves with these guidelines prior to undertaking Outreach and should carry a copy with them on Outreach to refer to if needed. During Outreach, Red Cross people hold many different position titles depending on the state or territory, or whether Outreach is being conducted in an activation context or not. Throughout this guideline document the following terms are used:

Outreach Team Member Red Cross person conducting Outreach

Outreach Coordinator Red Cross person managing a particular Outreach event (also called a Team Leader during activation)

Line Manager A Red Cross person’s direct manager

2 Emergency Services Outreach Guidelines 3 Section One Safety

The safety and well-being of Red Cross should be shown when driving through people always comes first when conducting affected areas as road conditions may have outreach. Under no circumstances should been affected Red Cross people compromise their own • At times Outreach can involve driving long safety for the sake of visiting residents. distances, always drive appropriate When conducting Outreach you may to conditions and ensure that you follow encounter some hazards that you may the Red Cross vehicle policy (available from not be familiar with, the following hazards your Outreach Coordinator) should be specifically considered before • Do not drive on dirt roads after dark, if driving undertaking Outreach. through rural or regional areas, be particularly Hazards careful driving at dawn or dusk as there can be increased wildlife (kangaroos, rabbits etc.) • After an emergency there can be increased on the road environmental or infrastructural hazards in the area, such as: Weather - Structurally unsound buildings or structures • Outreach can be undertaken in all weather that may fall conditions, including extreme heat and cold, - Burnt or partially burnt trees that may fall make sure you dress appropriately to stay - Flood-water or contaminated water cool or warm and protected from the sun - Storm debris such as broken glass, corrugated (you will be provided with weather iron, wire etc. appropriate Personal Protective Equipment) - Fallen power lines • Stay hydrated, drink plenty of water • You should be aware of these possible hazards and keep safe from them at all times • Mosquitoes can breed quickly in stagnant water after a flood or a storm, keep skin Roads and driving covered and wear mosquito repellent • Road surfaces can be damaged by floods and • Wear comfortable shoes as you may storms or emergencies may have caused trees be required to walk significant distances or other debris to block roads, extra caution Australian Red Cross / Luke Plummer / Luke Cross Red Australian 4 Emergency Services Outreach Guidelines 5 Section Two • The purpose of the Outreach includes: Needs assessment form - To deliver Psychological First Aid (PFA) • Needs assessment forms are aimed Privacy, - To contribute to a general needs assessment at gathering information to provide of the area to pass onto relevant agencies a generalised needs analysis to local council - To provide information to affected people or relevant service agencies and to advocate information - To make referrals where required for relevant and appropriate services and support for affected communities - Any other outcomes as agreed to between gathering Red Cross and partner agencies • Needs assessment may include practical, • It is important to explain that when making physical and psychosocial information a general needs assessment, no identifying • Includes specific recovery questions for or personal details will be recorded (name, Red Cross and other agencies to gather address etc.) The primary aim of Outreach is to provide Psychological information regarding community strengths, First Aid (PFA) to individuals, families and households • Personal and identifying details will only be recovery needs and concerns affected by emergencies. Secondary aims such as making recorded if making a referral, in which case • Needs assessment forms are not aimed the affected resident must read, understand needs assessments, gathering or providing information at providing specific, property or personal and sign a full privacy statement to give their should never be undertaken at the expense of providing information to council or service agencies. consent (please see specific referral guidelines) PFA and should never compromise PFA principles. If this is required, a full referral form must be completed and signed During Outreach, Red Cross people must explain • Below is an example script. This script is a guide only and is not intended to be followed to everyone they visit the purpose of the Outreach visit, How needs assessment forms are used word for word, as long as you make sure that what information they will be recording and how this will the three points above are made clear. • These forms remain the property of Red Cross be used. They must ensure each resident they speak and are not provided to any other agency to understands this and is happy for Red Cross to gather and pass on relevant information. • Information gathered is collated into “My name is ... and I am from Red Cross. an Outreach report that is provided to local We are in the area today to see how you are council, other relevant service agencies, after the recent (name emergency). Red Cross donor organisations and stakeholders, staff and volunteers Based on the conversation we have with you and with others in the area, views, opinions • On completion of the Outreach report, and concerns may be included in a report we individual needs assessment forms write for local agencies so that we can make are destroyed sure the needs of the community are being met. Any personal information we collect is for • Outreach reports are available upon request administrative purposes only and will not be to residents included in the report.”

6 Emergency Services Outreach Guidelines 7 Section Three Referrals

A referral happens when a resident • A referral form includes the full privacy requests Red Cross to make contact statement which must be understood and signed by the resident with another agency or service provider on their behalf. The residents • When taking a referral, Red Cross people must details are taken and passed on also leave a copy of the privacy statement to the relevant agency by Red Cross. with the resident for future reference Red Cross then follows up with the • After passing on referral forms to the resident and the agency to ensure appropriate agency, Red Cross will follow contact has been made. up with the resident to ensure they have been contacted • A referral should be taken as a last resort only. Red Cross people should encourage residents • Red Cross will destroy or de-identify referral to contact the required service agency forms as soon as the resident for whom the themselves, thereby promoting self-efficacy referral is for has been contacted to confirm that they have been contacted by the relevant • A referral is required in order to provide any service agency agency with specific personal or property details, no matter what service is required • Referral forms must be kept secure and – i.e.; removing unsafe trees/financial advice viewed only by appropriate Red Cross people /counselling services until they are passed onto the relevant agency Australian Red Cross / Rodney Dekker / Rodney Cross Red Australian 8 Emergency Services Outreach Guidelines 9 Section Four Entering a Property

In most cases during Outreach, • Always look out for their own safety first. Red Cross arrives at properties If they feel uneasy or uncomfortable entering a property, do not enter unannounced and without an invitation from the resident. Many properties, • Always ensure they are in a Red Cross marked particularly rural properties may have car and wearing uniform and an identification ‘do not enter’, ‘private property’ badge to identify themselves quickly and easily as Red Cross or ‘keep out’ signs. This can increase after an emergency as people wish • Call their Outreach Coordinator if they have to keep the media or ‘emergency any concerns tourists’ out of their property. Many Some properties may have aggressive looking roads may be closed ‘except for local dogs, ‘beware of the dog’ signs or may appear traffic’ also for this purpose. In this unsafe for another reason. Outreach Team situation, Red Cross people should: Members should use their own discretion when deciding whether to enter these properties or • Respect resident’s privacy. If someone has a not. Red Cross People should never put them- ‘do not enter’ or ‘keep out’ sign, respect this selves in a situation in which they feel unsafe, and do not enter. If it is appropriate, leave a if in doubt, do not enter. card in the letterbox or on the gate Australian Red Cross / Stephen McInvenna / Stephen Cross Red Australian 10 Emergency Services Outreach Guidelines 11 Section Five Child Protection

Australian Red Cross is a child safe • If a Red Cross person suspects a child is organisation. All Red Cross people in immediate danger, they should call 000. involved in Outreach activities must Children home alone have signed the updated Red Cross While conducting Outreach activities, Red Cross Child Protection Policy and be provided people may encounter children at home without with a copy of the Red Cross Child an adult present. In this circumstance people Protection Handbook. Red Cross people should: who have not signed the Red Cross • Ensure the immediate safety of the child. Child Protection Policy are not able If the child is in immediate danger, call 000 to undertake Outreach activities. • Do not engage the child in in-depth For these purposes, child abuse is defined as: conversation. Do not attempt to complete - Physical abuse a needs assessment, provide general - Sexual abuse or specific information - Emotional abuse • Leave a calling card for the appropriate adult/s - Neglect and leave the property. - Exploitation • Do not enter the house • If, during Outreach activities, a Red Cross person witnesses, suspects or has child abuse • If the child appears distressed about being disclosed to them, they must report it to their left alone, call your Outreach Coordinator Outreach Coordinator immediately for further advice

• Support or advice during this process can be For more information please refer to the obtained from Red Cross Child Safe Contact Red Cross Child Protection Policy and Child Officers. Contact details for Child Safe Contact Protection Handbook Officers in your state or territory can be obtained from your Outreach Coordinator Australian Red Cross / Rodney Dekker / Rodney Cross Red Australian 12 Emergency Services Outreach Guidelines 13 Section Six Family Violence

Family violence includes violence or abuse against a partner, child (including an adult child), sibling or other close relative or someone within a shared household or domestic relationship. For these purposes, family violence is defined as:

- physical abuse - sexual abuse - emotional abuse - financial abuse - threats of violence or abuse - exploitation

• If, during Outreach activities, a Red Cross person witnesses, suspects or has family violence disclosed to them, they must report it to their Outreach Coordinator immediately

• Outreach Coordinators are to pass the report onto a Red Cross Staff Member who will inform the relevant State Manager, Emergency Services

• If a Red Cross person suspects someone is in immediate danger, call 000 Australian Red Cross / Luke Plummer / Luke Cross Red Australian 14 Emergency Services Outreach Guidelines 15 Section Seven Illegal Activity

If a Red Cross person witnesses illegal • If a Red Cross person feels uncomfortable, activity at a home or property whilst they should remove themselves from the situation or leave the property conducting Outreach (other than child abuse), they are not obliged to report • If a Red Cross person feels comfortable it. The reputation of Red Cross in the and confident continuing with the visit, community as an impartial organisation they should do so and being welcomed into homes and • If, in consultation with the Outreach communities may be threatened Coordinator, a Red Cross person wishes if residents feel that Red Cross people to make a formal report of the illegal activity that was witnessed, then a report should are looking out for, and reporting be made to the Outreach Coordinator’s Line illegal activity. Manager who will ensure that Red Cross processes are followed. Luke Gracie Luke 16 Emergency Services Outreach Guidelines 17 Section Eight Aggressive Behaviour

Distress Anger / Frustration In conducting Outreach Red Cross people may • If the anger is directed at the situation, come across people that are very distressed at a government agency or organisation or upset, or who become distressed or upset or at Red Cross, people should use PFA whilst talking. This can be a difficult situation to techniques to try to assist them to calm down manage. • If anger is directed at a Red Cross person, they • If the resident is highly distressed or should remove themselves from the situation distraught, Red Cross people should use their PFA skills to assist them to calm down • If at any time a Red Cross person feels uncomfortable or unsafe, they should remove • It is the role of Red Cross people to listen themselves from the situation and to link these people with services or organisations that may assist them rather than • If a Red Cross person believes anyone trying to solve peoples’ problems for them is in immediate danger, they should call 000 or to offer advice Australian Red Cross / Rodney Dekker / Rodney Cross Red Australian 18 Emergency Services Outreach Guidelines 19 Section Nine

Self Harm

Written with the support of the Australian Psychological Society

Self harm can be described as repeated, • Encourage the resident to talk to their self-inflicted shallow yet painful injuries to friends and family- people they feel safe and the body such as scratching, burning, cutting, comfortable talking to banging, hitting or interfering with wound healing. The most common purpose of self- • Use PFA skills to encourage the resident harm is to try to reduce difficult emotions such to seek help such as a GP or counselling as anxiety, tension and/or to cope with • If the resident has injured themselves and an interpersonal difficulty when other strategies needs medical assistance, help them to access don’t seem to be working1. the help they need If, during Outreach a Red Cross person • If it is clear that the resident is unable to seek witnesses, suspects or has self-harm disclosed support or assistance themselves, offer to to them they should use their PFA skills to listen assist them with a referral for a counselling to the needs and concerns of the person or similar service • Listen to the resident if they want to talk • If a Red Cross person believes someone about how they are feeling is in immediate danger, call 000 • Be understanding, don’t judge

• Let the resident know that it is OK to talk about things that may be painful Australian Red Cross / Rodney Dekker / Rodney Cross Red Australian 20 Emergency Services Outreach Guidelines 1American psychiatric association (2013) diagnostic and statistical manual 21 of mental disorders (5th ed.), Arlington va, american psychiatric publishing. Section Ten

Suicide

Written with the support of the Australian Psychological Society

Suicidal behaviour results from a Other indirect signs that a resident might be not If a Red Cross person believes that the situation Outreach Coordinator guide: complex range of personal, social and doing so well are changes in behaviour that may is life threatening, call 000. • If you believe the situation is life threatening, have been noticed, such as withdrawing from call 000 situational issues affecting a person. family and friends, etc. Red Cross people conducting Outreach should Often it may appear that a particular never ignore, make light of or laugh off any • If (in an activation situation) Lifeline incident has ‘caused’ the suicide, In this instance a Red Cross person should: threat of suicide, even if it is couched as a joke. or another mental health service is involved however, when considered more A Red Cross person should let the person know in the response, call that service for assistance • Use their PFA skills to listen to the resident that they feel concerned about the seriousness closely there is usually a combination and link them with the appropriate support of what they have been told, and will contact • If it is not an activation situation, of issues or a pattern of earlier their Outreach Coordinator. Below is a suggested call Lifeline (13 11 14) or Kids Helpline • Stay calm, listen and acknowledge that the script for Red Cross people conducting for people under 25 (1800 55 1800) difficulties that are present2. persons concerns are real Outreach to use if they think a resident for further assistance and advice When conducting Outreach Red Cross people • Asks directly if the resident is considering is considering suicide. should listen for verbal signs that someone may • These events can be distressing for Red Cross or has thought about suicide be considering suicide. Comments that may people involved. Ensure appropriate support be concerning include: • Acknowledge that the resident is going is made available “As I’ve been listening to you I’ve been hearing through a very difficult time but remove • Indirect comments such as “it would all be how very distressed you are, and that you’ve The ultimate aim of a suicide intervention is that suicide as a solution easier if I was not here”, “sometimes I would even been thinking of hurting yourself. the resident is left safe and linked with a service like to just end it all” • Encourage the resident to talk to their friends That’s pretty serious. I think it would be good that they can access in an ongoing way. This or family for you to speak to someone who can help you may include support network such as family or • Jokes or casual threats to kill themselves with these feelings. I’m just letting you know friends or a more formal support such as their • Encourage the resident to talk to their GP that I’m going to call my supervisor and let them GP or counselling service. • Idolisation or envy of others who have to access more specialist support. Ask them know, and see if we can get some extra support suicided to call their GP to make an appointment whilst for you.” • Direct statements or threats of suicide: you are still with them. “I think I will just kill myself”

22 Emergency Services Outreach Guidelines 2 http://www.psychology.org.au/community/suicide/ 23 24 Emergency Services Outreach Guidelines Dekker / Rodney Cross Red Australian Notes www.redcross.org.au

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