Annual Report 2020 Our Journey Contents
1923 Australian Mothercraft Society was founded by Sir Truby King. First baby clinic opened in Coogee in 1924. 04 06 08 Larger hospital purchased with mobile clinics supporting families 1927 in the outer areas of Sydney. A Year in Review Karitane Strategy The First 2,000 Days
Australian Mothercraft Society received government funding for the 2019-2021 Shape a Child’s Future 1966 first time. 1970 Changed name to Karitane Mothercraft Society. 09 10 12 Residential hospital moved to Carramar. 1994 Our Reach Our Impact Pandemic Response 1996 Changed name to Karitane and opened mental health services.
Volunteer home visiting program commenced in Fairfield, Liverpool 2000 and Bankstown.
2009 Karitane head office opened at 126 Horsley Drive, Carramar. 14 20 26 Our Services Prevention Services Early Intervention 2011 Karitane residential unit opened at Camden Hospital. Services
Camden toddler clinic opened by the Minister for Health and Minister 2012 of Medical Research, The Hon. Jillian Skinner, MP.
Major refurbishments at the residential unit at Carramar to provide 2013 family rooms for parents with more than one child. 32 38 40 Karitane website for parents and professionals launched. The Hon. Intensive Support Celebrating Dads Clinical Research 2014 Jillian Skinner, MP opened Karitane Gardens Camden, a new outdoor Services & Evidence Base play area for toddlers.
Karitane appointed an Aboriginal Liaison Officer and celebrated 2017 15 years of Lil Possums Aboriginal support playgroup.
Integrated care hubs opened at Westfield Bondi Junction and 46 48 55 2018 Oran Park Podium. Governance, Safety, People & Culture Financial Overview
Digital health hub with two new services — virtual home visits and Quality & Outcomes 2019 Internet-Parent Child Interaction therapy — opened by the Minister for Health and Medical Research, The Hon. Brad Hazzard, MP. Special thanks to our patron and Our digital transformation in response to the COVID-19 pandemic ambassador for 2020 created capability for new models of care, including virtual residential 58 their continued unit, virtual breastfeeding clinic and further expansion of integrated support of Karitane. care hubs in regional centres. Donors & Community Karitane patron, Karitane ambassador Ms Ita Buttrose AC, OBE Steve ‘Commando’ Willis 2 | Annual Report 2020 Karitane | 3 A Year in Review
We could not have foreseen the benefits in 2018 of building project for leading NGOs in Australia, and Sharlene Vlahos were successful in being our decision to introduce Karitane’s digital health hub supported by the NSW Department of Communities selected as part of the Plus One leadership program. and virtual care services which were fully supported and Justice and the Association of Children’s Welfare This wonderful program provided an opportunity by the NSW Government budget announcements and Agencies (ACWA). for corporates to invest in developing not-for-profit matched funding from South Western Sydney Local sector leaders and included leading edge companies Health District at that time. This early investment Integrated Care Hubs – First 2,000 Days such as the Atlassian Foundation, Koda Capital, and foundational work permitted us to pivot our We have expanded our sites for integrated care Lendlease, MinterEllison and Downer Group. We are CEO & Chairman entire service very rapidly and seamlessly to a 100% hubs in shopping centre locations – where support is very grateful to have been recognised and supported Foreword digital transformation across all points of care at accessible in the heart of the community, and where as a recipient of this opportunity and I know Sharlene the height of the pandemic. With our virtual care the focus on the first 2,000 days, early intervention found it to be extremely valuable. It has been another incredible year for Karitane strategy, we have continued our services, reached and prevention services is key. We have been as we deliver on our vision to lead early parenting families in many rural and regional centres and have supported by a variety of philanthropic, donor and Our Governance Changes services that empower families and children to be notably provided services to families from over 1,025 health districts, including Perpetual IMPACT Funding, We acknowledge the outstanding contribution of confident, safe and resilient. Of course, it’s also been postcodes across NSW. We are very pleased to share to bring this popular with parents model into the former board Chair Robert Casamento who retired a most extraordinary year of extreme circumstances our intervention outcomes and client experience Illawarra Shoalhaven Local Health District (ISLHD) in October 2019 after 12 years of service and we which has seen our communities experience severe feedback in the report. and the Hunter New England Local Health District welcome Lee Carpenter as our new Chairman. bushfires, drought, floods and the COVID-19 (HNELHD) with other locations in the planning phase. We also acknowledge the valuable contribution of pandemic. Our Staff, Our Strength Our established exemplar sites at Oran Park, proudly each of our board members and welcome Nicholas A major highlight has been to see the excellent results supported by the Perich family and South Western Nogarotto and Charmion Ingram to the board. We Parenting in a Pandemic from our focus on the culture, leadership, safety and Sydney Local Health District, and the Bondi Early were very fortunate to have Rad Sappany join our These events and COVID-19 have greatly impacted values within our organisation. In February 2020 we Parenting Store, now in a new partnership with South board for this year as part of The Observership parents and families, increasing their sense of undertook our Best Practice Australia Staff Cultural Eastern Sydney Local Health District (SESLHD), have Program and wish her well in pursuing her isolation, affecting social support networks, Survey to see how we were performing. Results continued to thrive. board career. increasing perinatal mental health issues, increasing were impressive and showed that Karitane achieved family violence reports and juggling parenting and We thank and appreciate our committed volunteers, a “Culture of Success” and performed above Expanding Work with Families with work from home, often with childcare and home partners and supporters. benchmark as compared to peer services on 132 Vulnerabilities schooling responsibilities. We saw a 125% increase out of 142 responses. We excelled in the following Karitane was very proud to be one of the first The past 12 months have seen so many exciting in referrals week by week through the March-June areas: our leadership landscape, identity and organisations to sign a five-year Human Services achievements for Karitane and enormous resilience COVID-19 period and would like to acknowledge direction, values, risks at work, engaging our people, Agreement with the NSW Department of through the challenges we faced as part of and thank the NSW Government, Minister Bronnie organisational change and client engagement. Communities and Justice to deliver a range of COVID-19. We are starting to give thought to our Taylor, the NSW Ministry of Health and South This was an inspiring boost for the teams and targeted early intervention services to the families centenary celebrations of 2023 and look forward to Western Sydney Local Health District (SWSLHD) demonstrates the true spirit of collaboration, of the South Western Sydney community. We are Karitane continuing our dedicated work. This is a for acting swiftly and providing additional resources excellence, innovation and respect – the underpinning also delighted to be extending some of our programs small highlight of the fantastic achievements of our that have greatly assisted our teams to respond and lived values of Karitane. into Taree – in the Hunter New England Local Health staff and there are many more you can read about in to the increased demand for parenting support. District – in collaboration with the First Steps Count this 2020 Annual Report. We would also like to thank a private donor who Strategic Collaboration and Partnerships initiative and Biripi Aboriginal Corporation Medical has generously and consistently been by our side, Our collaborations and partnerships have continued Centre to launch the Volunteer Family Connect providing additional financial support to ensure to go from strength to strength and many are program and other programs to follow. Karitane could reach out to families in some of the detailed in the body of this report. We have nurtured most disadvantaged locations. Lee Carpenter Grainne O’Loughlin our enduring partnerships with new initiatives and Leadership Highlights Chairman CEO and Company Secretary We are always, but now more than ever, deeply fostered other exciting new collaborations over It has been a great privilege to be nominated and appreciative for all of the Karitane team who came the last 12 months with UNICEF Australia, PANDA, accept the position of Chair of the Australasian together and worked absolutely tirelessly, with and Parents At Work, with the national Working Association of Parenting and Child Health (AAPCH). enormous commitment to help and support our Parent Survey and family-inclusive workplace This membership organisation focuses on bringing parents through some of the toughest of times recommendations. We are also thrilled to partner with best practice initiatives and advocacy for parents and and to support us and one another through a the Parenting Research Centre on several initiatives families across Australia and New Zealand. Karitane fiercely busy period. including the leadership of a telepractice capacity- 4 | Annual Report 2020 Karitane | 5 Karitane Strategy 2019-2021
Vision Mission Leaders in To provide accessible, evidence-based services that support early parenting services that families to parent confidently. Through research, advocacy empower families and collaboration, we promote excellence in our care across and children to be confident, safe a diverse community. and resilient. Strategic Directions Grow Our 1. Grow Our Programs & Services Programs & Services Deliver accessible and innovative programs and services that build parenting capacity and promote Karitane’s reputation as a national and international thought-leader in early parenting practices.
Refine Systems 2. Refine Systems & Structures & Structures Achieve a values-aligned organisational culture with robust governance practices, supported by contemporary systems and service delivery models.
Strengthen Leadership 3. Strengthen Leadership Develop a leadership framework that sets international benchmarks in parenting support practices and builds the capacity of all our leaders to inspire, influence and develop individuals and teams. Expand Collaboration Strategic Directions & Partnerships 4. Expand Collaboration & Partnerships Expand relationships with strategic partners to promote organisational growth, pursue new opportunities and build community recognition.
Ensure Financial Sustainability 5. Ensure Financial Sustainability A sustainable approach to financial management supported by diversified funding streams, sound investment strategies and appropriate budgetary controls, that secures the financial future for Karitane’s programs and services. Respect Innovation Collaboration Excellence Our Relationships Our Future Focus Our Partnership Our Standards Approach
Values
6 | Annual Report 2020 Karitane | 7 The First 2,000 Days Shape Our Reach a Child’s Future Supporting Families Across Australia
Early brain development forms Critical period for early the base for all future learning: intervention to change the Referrals from cognitive, behavioural and social. trajectory of a child’s life. over 1,025 postcodes 90% of brain growth happens before a child optimal brain development, which provides the is 5 years old. foundation for skills a child needs for school and for this year life. The neural pathways, the connections and the At birth, the average baby’s brain is about a quarter wiring are all influenced by how parents and carers of the size of the average adult brain. Incredibly, it interact with their children. Their relationship with their doubles in size in the first year. It keeps growing to child will help determine their relationships in life. about 80% of adult size by age 3 and 90% — nearly full-grown — by age 5. Karitane is aligned to the NSW Health First 2,000 Days Framework and supports families through this The first 2,000 days are a critical time for physical, Virtual services breaking critical time by providing evidence-based services, cognitive, social and emotional development. What down geographical barriers education and support to families. happens in this time shapes a child’s future. Positive Services include: the Karitane Careline, early experiences and secure attachment lead to workshop webinars, the virtual breastfeeding clinic, virtual home visits, National Support virtual residential unit, the toddler clinic Services include: parenting with Internet-Parent Child Interaction support in the workplace and Therapy (I-PCIT). the kids behaviour clinic.
Tweed Heads Northern Strategic Objective 1 • Multidisciplinary team with leading expertise in child and family health NSW All staff in the NSW health and perinatal infant mental health. system understand and • We provide research, education and training to health professionals for Casino promote the importance of Hunter New early intervention and prevention programs including Family Partnership England the first 2,000 days and the training, Parent Child Interaction Therapy (PCIT), the Masters of Child Halls Creek best opportunities for action. and Family Health at Western Sydney University, and new graduate child Blue Vale Appleby Mid Coffs and family health nurse and transition to professional practice programs. Western NSW North Harbour Far West Coast Macksville • Senior advisor to government, non-government agencies and peak Port committees for early intervention and prevention, working across health Macquarie and welfare sectors.
Dubbo Strategic Objective 2 • Collaborative strategic partnerships with local health districts, primary health networks and non-government agencies. Central Coast The NSW health system Nepean Blue provides care to all and • Leader in the development of integrated care hubs, and co-location Mountains Northern Sydney works in partnership to of child and family and perinatal and infant mental health services Cowra Western Sydney Dareton Bathurst promote health, wellbeing, with local health districts and non-government agencies across NSW, Sydney Griffith Young capacity and resilience delivering a comprehensive stepped care model of early intervention Murrumbidgee South Eastern Sydney during the first 2,000 days. and prevention services for families. Leeton South Western Sydney Yass
Illawarra Shoalhaven Strategic Objective 3 • Karitane ensures families receive the right service in the right place at Braidwood The NSW health system the right time, with a continuum of care from early intervention through provides additional services to comprehensive care. Southern NSW for those who need • Offering blended models of modality, face-to-face and virtual services, specialised help, when in-centre care, community programs and integrated care hubs. Pambula they need it. Demand across local health districts
8 | Annual Report 2020 Karitane | 9 “Karitane is amazing. They are nurturing and supportive of both parents and children. They are empathetic and encouraging and 30,480 I gained so much confidence thanks to them. Occasions of service Thank you Karitane!“
3,365 108,718 4 Referrals New services +17% increase Lives touched by Karitane 12,968 6,361 Telehealth Integrated care consultations hub clients 4,737 Families Careline calls from different +16% increase 1,025 postcodes 5,498 2,996 Families Parents supported supported by in the workplace 2,782 parenting groups, Dads supported workshops and in consultations webinars and groups 356 86,290 Clients Parents supported via 97% identifying as website and social media Our Parents Aboriginal or found the Torres Strait Client service Islander Impact helpful 99% satisfaction July 1st to June 30th 2020 10 | Annual Report 2020 Karitane | 11 Pandemic Response Snapshot April - June 2020 Over 3,920 telehealth consultations Rapid and Karitane worked closely with government and guided by advice from the NSW Public Health Unit, Parenting Workshop Webinars significant workforce NSW Health in response to COVID-19 with a 100% and we took all possible precautions to respond to (720 registrations) capability building. digital transformation of services to ensure safe and the risk of community transmission of Coronavirus. Mental Health Virtual 19% 3% Support Supported Playgroups Over 80 health accessible care for families. This digital transformation This included screening all families and staff attending 9% & Virtual Volunteer professionals created capability for new virtual models of care and our services each day, adhering to the recommended Family Connect trained to use digital also a new foundation for the future provision of early physical distancing guidelines and introducing platforms. parenting services. To ensure parents and carers a range of enhanced infection control measures (Child and family health received the support they needed at a time when including increased cleaning schedules at all sites, 17% Toddler Behaviour nurses, allied health physical access to GPs and other support services use of masks in clinical areas and strict hand hygiene Virtual Support professionals and GPs.) were less available in the community, Karitane also compliance. “It has been a fabulous opportunity enabled parents to self-refer to our services. Virtual Residential 30% Our team worked with families to match the right to apply face-to-face child and Unit family healthcare to a virtual We continue to offer an extended range of virtual service and mode of delivery along our stepped care Intensive support 23% Virtual Home Visits platform of residential care to services, which have achieved such positive model, depending on each family’s individual needs. with over 20 continue to connect, support outcomes for families and exceptional feedback. The safety and wellbeing of our staff, children and consultations per and transform the lives of families family during their Our reintroduction of face-to-face services was their families is always our highest priority. across NSW at this challenging residential stay time.” Jennifer, child and family Digital Services health nurse Providing accessible care and empowering families at home What Parents Say
Mental Health Exceptional client Careline Parenting Workshop Virtual Breastfeeding of families said of parents found Virtual Home Visits Virtual Support the service Webinars Clinic their parenting satisfaction 97% knowledge 85% extremely or 70 net promoter score for improved very helpful families recommending Virtual continuum of care for families Karitane to a friend Services range from brief interventions to intensive support “Being able to access this support from our own home was a significant contributor to the overall success of this service. With the assistance of your very skilled, professional and compassionate team we were able to achieve our goals as a family.” Lauren, virtual residential stay client Online Online Evidence- Virtual Toddler Virtual Supported Based Parenting Volunteer “This service has empowered us to be more confident parents.” James, virtual residential stay client Behaviour Virtual Residential Unit Playgroups Programs Family Connect Support “We are so thankful, we’ve seen some incredible outcomes in a very short period of time.” Stephanie, virtual home visit client “This is the best advice I have ever received.” Paula, parenting workshop webinar client
Increasing Need for Support Top 3 primary reasons for referral 64% 135% 180% Self-referrals 89,800 41,870 26,400 Increase in referrals Increase in Careline calls 1 website Page Views Sessions Parents Sleep & settling 119% 49% 140% April - June vs same time last year Referrals from 2 ALL across NSW Toddler behaviour Digital transformation responding to pandemic created capability for new models 3 36% of care, and a new foundation for the future of early parenting services. Families from over 640 Mental health Health professional different postcodes referrals
12 | Annual Report 2020 Karitane | 13 Our Services
Highlights At Karitane, we... Karitane is a registered charity and not-for-profit early parenting organisation within NSW. We support Evidence-based families, build parenting capacity, enhance parent- child relationships, and strengthen family connections Value-based healthcare with their communities. Outcome driven All our services are evidence-based and ARE Multidisciplinary team demonstrate significant measurable outcomes for Working within a Family Partnership Model (FPM) families. Services are delivered by a highly trained, Supporting attachment-based relationships multidisciplinary professional team of child and family health nurses, perinatal infant mental health nurses, Innovative leaders in service delivery paediatricians, GPs, social workers, psychologists and psychiatrists. Karitane provides a stepped care model of intervention, ranging from brief interventions external Aboriginal partners and communities. The Children from birth - 5 years to intensive support for new parents — particularly in ALO engages with families at first contact through Mums, dads and carers the first 2,000 days. Our care includes support with our centralised intake team, and continues to support Metro, rural and regional families across NSW with growing sleep and settling, feeding and nutrition, establishing each family through their service provision and national programs routines, toddler behavior, conduct disorders and discharge planning process. We work closely with emotional dysregulation, and pre and postnatal Culturally and linguistically diverse communities and Indigenous NSW-wide Aboriginal communities, and in the last HELP families anxiety and depression. year have provided support to over 356 families who Families with vulnerabilities, including young parents and teen identify as Aboriginal or Torres Strait Islander. Our continuum of care and expertise extends into parents in custody a range of services for families facing adversity, All our services are proudly partner and father- Working parents higher vulnerabilities, and a range of psychosocial inclusive, as we recognise the equally important role risk factors. Karitane offers programs for Indigenous partners and dads play in parenting their children. families, families from culturally and linguistically Our father-inclusive practice committee has a Support parenting challenges around: sleep and settling, feeding diverse communities, families who are socially multidisciplinary membership. For more information and nutrition, establishing routines, toddler behavior, adjusting to isolated with minimal support, young parents, and on our father-inclusive practice and initiatives, see the parenting teen parents in custody. Karitane’s services work Celebrating Dads section on page 38. within a child-centred framework, where the safety, We also specialise in: welfare and wellbeing of children is our key focus. To ensure we can effectively match families to Toddler behaviour, conduct disorders and emotional dysregulation Our programs are delivered within a trauma-informed the right level of care and support at the right DO Postnatal depression and anxiety practice framework, helping families and communities time, Karitane offers a unique and comprehensive Trauma-informed practice raise confident, healthy and happy children. centralised intake and triage process. This system Young parent programs Karitane’s services help families build stronger provides a NSW-wide single point of entry for access, Programs for dads relationships, improve mental health, and break the assessment and referral, to help families navigate the cycle of intergenerational trauma. appropriate level and point of care for them.
Our commitment to our second Reconciliation Action Plan continues to provide culturally safe and appropriate care for families identifying as Aboriginal or Torres Strait Islander. Our Karitane Aboriginal Liaison Officer (ALO) works across the organisation to support and strengthen relationships between clinicians and families identifying as Aboriginal or Torres Strait Islander, and build relationships with
14 | Annual Report 2020 Karitane | 15 Leading NGO Telepractice Collaborative “The development Venture of the Telepractice With expertise in the digital health hub, recent Framework will upscaling of virtual services, and training of health help vulnerable and professionals, Karitane — in partnership with the isolated families Parenting Research Centre (PRC) — has been across NSW receive funded by the NSW Department of Communities the parenting and Justice, the Association of Children’s Welfare support they Agencies (ACWA), and a group of seven leading require to manage non-government organisations (NGO), to lead a the challenges of collaboration that will advance telepractice service COVID-19. The work is an excellent example delivery and provide more effective support to families. of collaboration between government and the non-government sector, to design and Through COVID-19, there has also been an increase develop telepractice solutions for families across NGO service providers in families experiencing unable to access face-to-face services.” a range of significant hardships, greatly reduced face- Minister for Families, Communities and Disability to-face support, and a spike in deteriorating mental Services, the Hon. Gareth Ward, MP health and domestic violence. As virtual services can help break down barriers and ensure families across Australia receive critical support, ACWA established “What is incredible is the NGO COVID-19 Telepractice Venture. the fact that a number This collaboration will embed a structured approach of programs now to the adoption, adaptation, design and development have state-wide reach of telepractice solutions for children and families. with the use of virtual Leading Virtual Care Service Together, we will build NGO capacity to deliver platforms. Services quality, consistent telepractice services to children that were once only Innovative early parenting services, virtual parenting groups, and workshop webinars. and families, and create a virtual continuum of care localised, are now accelerating accessibility to families Our digital transformation response to the pandemic and support for the sector. able to reach people across Australia. created capability for new models of care, and a new in different locations. We provide accessible care for families across foundation for the future of early parenting services. This is a great example NSW, with a mix of face-to-face and virtual services. We are in the midst of establishing new, exciting and where the sector has come together rapidly Karitane is committed to reaching more families truly blended face-to-face and virtual models of care and accelerating access to parenting support. As throughout Karitane’s services. to support each other to adapt to changing such, we have continued to build our Karitane digital circumstances — all while continuing to This year, Karitane was featured by Health Leader health hub offering, which was officially launched provide high-quality services to families most TV, a program developed in partnership with the by the Hon. Brad Hazzard, MP, Minister for Health in need. We want to look at how we embed Australasian College of Health Service Management and Medical Research, in 2018. We have also led a that flexibility and opportunity across a range (ACHSM). Our digital delivery platforms — including variety of virtual and telehealth services including the of programs and support the sector with I-PCIT and virtual home visits — were showcased in Careline, virtual home visits, Internet-Parent Child the innovation and technology report. The program good practice guides.” Interaction Therapy (I-PCIT), and webinars in the highlighted how our innovative, evidence-based Department of Communities and Justice Deputy workplace. services support new parents through common Secretary, Simone Walker In response to COVID-19, Karitane was able to rapidly parenting challenges from the comfort of their scale up the foundational work of the digital health own homes, across NSW — including regional and hub — training a further 85 clinicians on the NSW remote regions. Health Pexip platform to ensure the safe, competent We are proud to be a leader in the delivery of and comprehensive delivery of increased virtual care accessible, innovative early parenting programs, options across the breadth of Karitane services. This and services that build parenting capacity and help included the launch of new virtual services: virtual accelerate accessibility to Australian families. residential units, the virtual breastfeeding clinic, virtual supported playgroups, virtual volunteer home visiting, 16 | Annual Report 2020 Karitane | 17 Our Services
The first2,000 days shape a child’s future
Sleep & Settling Feeding & Establishing Toddler Perinatal Infant Families with Nutrition Routines Behaviour Mental Health Vulnerabilities
, in the right place, care at th ht e r rig igh e t Th tim e Parenting Centres & Evidence- Virtual Home Visits Based Parenting Programs
Parenting Workshop Residential Services Webinars Integrated & Virtual Residential Care Hubs Stay Virtual Perinatal Infant Mental Breastfeeding Health Service Careline Clinic
Karitane Continuum of Care Prevention Early Intervention Intensive Support
Website & Social Media Teenage Pregnancy Toddler Clinics - Parent Peer Support Child Interaction Therapy (PCIT) & Parenting Support Program Internet-PCIT e R in the Workplace c e i s Targeted Early t e c a Intervention ra rc Programs p h Volunteer Family r , Connect u ed o u Young Parents in of ca Custody Parenting s ti Program n on tio an da d fa oun mil he f y partnership are t
Virtual service and options available
18 | Annual Report 2020 Karitane | 19 Tips to Manage Behaviour • Your toddler needs you to be in tune and responsive to their needs in a kind, predictable and consistent way. • They need boundaries and guidance as they learn about the world. • When talking to your toddler, get down to their eye level and gain their attention. “The best advice I have ever • Pay attention to the behaviour you desire, giving labelled praise, e.g. ‘Thank you for packing away the toys – great job’. • Offer clear, simple instructions. • Divert and distract your toddler from unwanted behaviour. • Spend time playing and sharing experiences with your toddler – they love being with you. • Allow opportunities to problem-solve but stay close and been given, thank you.” Prevention offer help if needed. • Celebrate success, as this builds self-esteem and confidence. • Talk to your toddler and give them words to describe 6,700 how they’re feeling. • Try to limit the word ‘no’ in instructions e.g. ‘We play Behaviour gently with our toys’. • Ensure your toddler has time to transition from one Parent activity to another. They are more likely to cooperate. Your toddler is exploring the world around them full of curiosity and energy, discovering how the world works and where • Be consistent and predictable. Mealtime Tips they fit in. It can be a challenging time for parents – but • Let your toddler know ahead of time that the meal will with predictability and consistency, you can enjoy this stage be ready soon. together. Safety • Sit down together when eating, preferably at a table with the family. Mealtimes provide an opportunity to be What to Expect • Keep your toddler close and hold hands when out and with your child and role model positive eating habits. about. Facebook followers: +37% • Your toddler is learning to regulate their big emotions. • Try to keep mealtimes regular and predictable. They are likely to have tantrums. • If your toddler is having a tantrum, ensure they will not injure themselves from their surroundings. • Make your toddler’s evening meal early to avoid being Tips for Introducing Solids • Your toddler is trying to understand the world around them. over tired. Our Services They push boundaries to test what the rules and limits are. • Offer solid food on a spoon 30 minutes after a milk feed. g to be more independent and • Involve your toddler in preparing their meals. • Your toddler is learnin • Start slowly – offer solids once per day and work up to 3 assertive. • Encourage your toddler to taste new foods, offer their times per day over a 4-week period. play and interact with others. favourites in combination with new foods. • Your toddler is learning how to • Start with pureed texture and progress to family foods by 12 • Allow time for your toddler to touch and smell their food. • Toddlers have shorter attention spans than older children months. • Praise your child for trying new foods, eating finger and adults. • Offer iron rich foods like iron fortified cereals, meat, poultry, foods, using a spoon or waiting their turn. fish, vegetables, fruits, legumes and tofu. • Your toddler can’t yet see that their actions have an effect on others. Feeding • Reduce distractions like television and electronic • You can introduce foods in any order. devices. • Allow your baby to decide when they have had enough. Challenges From 12 months of age, toddlers should eat family meals. Offer a • Try to limit their eating time to 30 minutes in order to These signs include turning or looking away, pushing food • It can be hard to manage your toddler’s behaviour. range of nutritious foods from the five food groups recommended establish a routine. out or closing their mouth, playing with or throwing food. by the Australian Dietary Guidelines. Be guided by your child – • From 6 months of age, you can int • How you feel can have an impact on your toddler, so it’s • Avoid take away or pre-packaged foods that contain roduce a cup for water. don’t force them to eat if they aren’t hungry and don’t withhold important to manage stress and take the time to calm high levels of salt and fat. • Gradually wean off bottles by 12 months of age. healthy food when they are. yourself and then reconnect with your toddler. • Avoid using sweets or chocolate as rewards. • Toddlers are very responsive to the environment around What to Expect • Toddler milks are not required. Introducing Solids Sharing a meal is a sociable and enjoyable experience. them. Feeling hungry, tired or unwell can all impact your • Large amounts of milk, juice and cordial will fill them up, Where possible have your meals with your baby. Family toddler’s mood and behaviour. • Many toddlers can be fussy eaters. Factors that can affect affecting their appetite. meal times are a great way to connect each day. your toddler’s appetite include: activity levels, sleeping Starting solids is an exciting time. From 6 months milk alone won’t patterns and health. meet yourBreastfeeding baby’s nutritional or developmentalTips needs, so it’s • As long as your toddler is active, well and eating a variety of recommended to introduce solids at this time (unless medically 16,800 Safety • Ensure your baby is properly attached to your breast (your healthy foods, there is no cause for concern. advised by a health professional). • Stay with your child at mealtimes. baby’s mouth is open wide with the top and bottom lips • This is a time of exploration and learning for your toddler, so curled out, not tucked in). • Always check the temperature of the food before allowing What to Expect expect some mess and use surfaces that are easy to clean. • If your baby is attached properly, most of the areola is usually your child to eat it. You don’t want to feed your child • A variety of foods other than milk are recommended when your in their mouth and there is no pain. Challenges something that’s too hot. baby begins displaying these signs: • If you have pain, carefully take your baby off your breast and • Seat your child securely and place food within easy reaching - Tongue-extrusion has disappeared (stopped pushing objects out • There may be times your toddler will eat foods and then then reattach. If you have a toddler behaviour question, call Karitane Careline 1300refuse 227 the same 464 foods the very next day. distance. of their mouth automatically). • It may take many tries before they will accept new foods. • Safely store any uneaten food for later if your toddler - Good head control when sitting in a supported position. Tips for Healthy Development• It’s common for toddlers to throw food, they may be testing becomes hungry again. - Interested in others eating. - NSW • Children learn through playing andyour interacting reactions. with Milk alone no longer satisfies hunger. Ministry of Health, Facebook Live views people. Ensure your toddler has• lotsThis of isopportunities a time for experimenting with the feel and smell of 2012 to play and explore. food, or what sound it makes when dropped. You decide what foods, Challenges • Join in and play with your toddler• eachSome day toddlers with toys can drag out mealtime. your toddler decides how much. • Getting messy, spitting out food or even gagging can be normal as your baby learns to eat solids. that promote imaginative play, such as blocks, toy • Breastfeeding is the perfect time to bond and connect with animals, cooking sets, cars and trains. - The gag. Some reflex tips helps include: prevent your baby fro your baby m choking. • Play outside. Feeding - Breastfeeding - •Soft Some words. babies have a change in digestion when starting solids. Safety - Gentle If constipation touches. occurs, introduce fibrous foods like pear, kiwi fruit • Join a playgroup where your toddler can learn to play and prunes, avoid bananas, persimmon and starchy food for a • Stay with your baby at meal times. Speaking to your baby while feeding. and share with others. - few days. • Use a harness in high chairs. Feeding can be an enjoyable, shared family experience and a great • Have crayons/pencils/paint for your child. way to bond. In the early stages of feeding, you and your baby will • Even without teeth your baby can learn to chew. Start cleaning • For infants under 12 months, avoid whole nuts, seeds, hard fruit, • Try new activities – practise builds confidence and learn a lot from one and another. Be patient, enjoy the experience teeth with a soft cloth and water once teeth appear. hard vegetables, honey and raw eggs. self-esteem. together. Safety• Your child won’t be used to new textures like lumpy or dry foods. • Avoid herbal teas, juice and soft drinks. • Read to your toddler everyday – this helps with Be patient as they learn to accept and enjoy solid foods. It is • Taking care of yourself while breastfeeding is important. Eat a well Karitane Continuum of Care language development. What to Expect important to encourage your child to progress to lumpy foods at
balanced around diet,6 to drink9 months. lots of water and rest where you can. • Meeting your baby’s nutritional needs is important for their growth, • Talk to your toddler about what is happening around • Avoid co-sleeping while breastfeeding. them. Describing what you see helps with language development and wellbeing. development. • It is recommended that babies are exclusively breastfed for the • Avoid alcohol, drugs and smoking. first 6 months. • Breastfeeding is recommended to continue until 12 months of Development Safety age and beyond. • Always make sure you keep your child’s environment If you have a feeding question, call Karitane Careline: 1300 227 464 • Babies may feed anywhere from 6 to 12 times per day. safe and monitorParenting screen use. Information For Mums & Dads: • Solid foods can be introduced at around 6 months of age. Parenting Information For Mums & Dads: Being a toddler is an exciting time with so much to learn and • Breastfeeding on demand is recommended to meet the changing 460 explore. It’s a time of change as your toddler learns many nutritional needs of your baby. It involves feeding your baby when new skills. Parents and carers have a great influence in the Toddlers they are showing signs of hunger. These include: development of their toddler. Remember – each child is unique Birth to 12 Months Prevention Early Intervention Intensive Support and will develop at their own pace. - Sucking noises. - Opening mouth. What to Expect - Turning towards your breast. If you have a feeding question call Karitane Careline: 1300 227 464 • Your toddler will develop many new skills as they grow. - Sucking fingers/fists. Some of these include: - Crying (this is usually the last cue). - Language and communication skills – by 3 years old, your toddler may speak 3 to 4 word sentences and be able to Challenges follow simple instructions. • Your baby might become fussy or refuse a feed. Reasons for this LinkedIn followers: +53% - Gross motor skills – like running, jumping, hopping, include: climbing, and learning to ride a tricycle or scooter. - Engorgement/getting a large amount of milk too quickly. - Problem solving – solving simple puzzles, using push and pull objects and playing with toys with buttons and levers. - Low milk supply/slow letdown. - Social and emotional development – managing their - Incorrect attachment to the breast. emotions and how to play with others. - Sore or damaged nipples. titis. - Fine motor skills – like holding a pencil, painting, using - Blocked ducts or mas scissors and building with blocks. - Your baby is overtired or just not hungry. • As many as 96% of breastfeeding mums experience nipple pain Challenges when first attaching their baby to the breast. You may feel like • Use of screens. It is recommended children 2 to 5 years old giving up but try and persist as it’s usually temporary and there are have no more than 1 hour of screen time per day (including so many benefits in breastfeeding for both you and your baby. television, tablets or smart phones). Seek help early if you are having challenges! • If your toddler is using screens, choose high quality programs and apps that have an educational component and stay with your child to ensure they are cyber safe. 7.6% If you have a breastfeeding question call Karitane Careline: 1300 227 464
If you have a question about development, call Karitane Careline: 1300 227 464 Careline Website LinkedIn engagement
Karitane Careline: 1300 227 464 Karitane Careline: 1300 227 464 Karitane offers a telephone support service with child The Karitane website provides a trusted source and family health nurses six days a week, providing of evidence-based information and education to guidance and support on topics including: support families on their parenting journey. The latest Workshop Webinars Parenting Support news, service information, brochures and videos are In response to COVID-19, Karitane recognised the • Sleep and settling in the Workplace available, along with the online referral form to our need for parents to continue to access information • Feeding Karitane continues to work with companies to centralised intake team. and support from child and family health nurses. complement their wellbeing inclusion and diversity • Playing and connecting with your baby So, in April 2020, we introduced new daily parenting This year, the website was redesigned and further policies, providing workplace parenting education • Your feelings and adjustment to parenting workshop webinars. enhanced to maximise mobile usage (more than and support to employees navigating the challenge of • Toddler behaviour 60% of all sessions), and improve navigation and Webinar topics include sleep and settling, balancing parenting with a career. We offer evidence- In response to the increase in demand for this design for a completely user-centric experience. breastfeeding, starting solids, fussy eaters, tricky based education programs and practical strategies service, we were pleased to receive support for New content was added, including five new pages toddlers, and routines. Each webinar is 45 minutes, for parenting, delivered in flexible formats (webinars, additional services from the Hon. Bronwyn Taylor, dedicated to dads: Becoming a Dad, Dads Make a during which our experienced child and family health podcasts, and Lunch ‘n’ Learns) in the workplace. MLC, Minister for Mental Health, Regional Youth Difference, My Relationships, Work-Life Balance, and nurse provides tips and strategies, with lots of These are delivered nationally through our education and Women. Wellbeing and Mental Health. opportunities for parents and carers to ask questions. team, our partnership with Parents At Work, and also The number of parents in each workshop is limited, Ngala in Western Australia. This means all parents, including partners, have more opportunity to access 296,000 Page views to ensure our experienced child and family health 3,629 Calls this year nurse can answer questions and provide support. parenting support. 129,300 Sessions +180% Increase in calls Karitane’s long-standing partnership with Parents through COVID-19 79,100 Users 99 Workshops held At Work continued, expanding this year to include a from April to June toddler podcast series: Little Toddler — Big Emotions! The 10-part series discusses all the tips and 720 Parents registered strategies for the most challenging and tricky toddler “Karitane saved my life, Social Media years. Having had over 2,870 listeners, our podcast is Karitane continues to maximise social media to currently ranked sixth in over 117 podcasts available my sanity and helped reach families and provide strategies promoting Prior to the webinars launching in April, Karitane through Parents At Work. positive parenting journeys. This year we launched on was delivering parenting groups and workshops me become the mum This year MinterEllison continued its bespoke Instagram, and continued to use LinkedIn to target face-to-face throughout the year. partnership with Karitane to support its national health professionals for service and research updates I am today!” workforce with practical parenting support in the and professional development opportunities. Karitane workplace. Through COVID-19, Karitane expanded was also invited to speak with the Mums at the Table support to include webinars on topics specific to the Facebook group, an online community of 30,000, 25 Face-to-face workshops pandemic: Talking to your Children about COVID-19, about parenting and the number one challenge: sleep Parents in attendance Working from Home, Supporting your Children’s and settling. 126 Learning from Home, and the popular Lunch ‘n’ Learns delivered virtually. 20 | Annual Report 2020 Karitane | 21 “Diversity in all its forms, is central to CEO, Grainne O’Loughlin said, “Parents taking stress effective responses to survey findings, which Industry Event collaboration. As part of our focus on home from work impacts not only on their wellbeing, identified the competing pressures of working and The Struggle of the Juggle is Real but also the wellbeing of their children — particularly caring impacting the wellbeing of Australian families creating a diverse and inclusive workplace, In August 2019, Karitane held a panel of industry when there is a lack of employer support.” — even before the additional pressures of COVID-19 we recognise the importance of supporting experts featuring Chair of the National Mental occurred. The group has published a new set of our caregivers in the workplace. The support Health Commission Lucinda Brogden, AM, Karitane nine family-friendly workplace recommendations, we have received from Karitane has been ambassador Steve ‘Commando’ Willis, Karitane designed to provide employers with a guide on how instrumental in providing support to our 67% Director of Education and Business Development best to support employees at this time. parents in the workplace, during what Of working parents reported feeling Sharlene Vlahos, The Fatherhood Founder Luke has been a particularly challenging and too emotionally or physically drained Benedictus, and MinterEllison Head of Talent unprecedented year. The training and support when they got home from work to Development Kate Cato. This panel explored the provided by Karitane has enabled us to create contribute to their family evolving role of being a dad, balancing family and a lasting impact for our people, particularly career, supporting parents at work, and mental health our community of parents.” 50% Of women and 33% in the workplace. To host over 100 CEOs and HR directors, Karitane partnered with leading recruiters MinterEllison Diversity and Inclusion Manager, of men who were parenting or Lauren Levin Moir Group and Peoplecorp, and was supported by caring said they were under ‘a lot’ McGrathNicol. or ‘a great deal’ of stress In Australia, 95% of primary parental leave is taken 10 Podcasts 33% by mothers and 34% of women who leave work to have a baby don’t return. Less than 1 in 20 fathers Of parents reported the combinations 2,870 Listeners take parental leave, with the average length of time of work and family responsibilities fathers take off work following the birth of their child Lunch ‘n’ Learns contributed to stress and tension averaging only 7.3 days. 1 in 5 mothers and 1 in 10 7 in the relationship with their partners fathers experience postnatal depression or anxiety. with 108 parents and with their children
5 Webinars with 50% 152 parents Of working parents had missed out on family activities in the past month, due to time they had to spend at work The results are in! The firstNational Working Families Survey reveals work- life conflict takes a toll on personal and family wellbeing. Observing the overwhelming results from the National Working Family Survey, a group of Australia’s leading Karitane was a proud lead sponsor of the first agencies dedicated to supporting families joined National Working Families Survey, conducted in forces with Karitane. They did this to highlight the July 2019 in collaboration with Parents At Work, important need for the business community to Australian corporates and two Australian universities. understand and respond to the real challenges facing Over 6,429 parents and carers from around Australia working families, particularly through the COVID-19 completed the survey, covering a range of issues crisis and beyond. This will help working parents families face when balancing parenting and a career. ‘bounce back’ to build a stronger, more sustainable Topics included parental leave support, flexible work way of working and caring for family. needs, childcare, and overall challenges experienced when managing a job and parenting demands. The The collaboration between Karitane, Parents At Work, survey was designed to understand how workplaces UNICEF Australia, and Perinatal Anxiety & Depression can better address ways of combining work with Australia (PANDA), brings together experts in parenting and caring responsibilities. parenting support, children’s rights and wellbeing, front-line mental health services, and groups that Findings revealed the significant toll work-life conflict specialise in assisting businesses to support working has on personal and family wellbeing. Karitane’s parents. This new partnership will focus on building
22 | Annual Report 2020 Karitane | 23 “The number one topic to employee assistance services is parenting. The best investment in prevention of mental health issues is parenting; we need to invest in parenting support services.” National Mental Health Commission Chair, Lucinda Brogden, AM
“We had two children in quick succession and my life descended into slapstick chaos. It changed every aspect of my life; how I felt about my job, my relationship, everything. I didn’t expect that. When men get together, we don’t connect as quickly as dads the way mums do. It’s a shame. We are all going through the same things, but we go through them on our own, in isolation. When our “We have 2,500 people and around 35% – 45% are parenting young boys were almost two years and six months and neither children. It was clear to us we needed to support them. We wanted to of them were sleeping, our GP suggested Karitane. We ensure they could access great quality information and support when they almost didn’t go, but we were desperate. What we found needed it, so we designed a program with Karitane. We moved away from was a crack team of professional baby-whisperers who just supporting parents in the transition back to work (after parental leave) to have navigated every childcare issue known to man. The providing ongoing support. Every parent needs access to Karitane the way experience changed our lives, and armed us with tactics, our team at MinterEllison do.” skills and strategies, making us more confident and MinterEllison Head of Talent Development, Kate Cato competent parents.” The Fatherhood Founder, Luke Benedictus
24 | Annual Report 2020 Karitane | 25 are integrated with the South Western Sydney child parenting service on the premises of Balmain Village Early Intervention and family health team, general practice and allied Health. The ICH allows easy access for families health partners. The hub was made possible thanks seeking more parenting information and support. Our Services to the philanthropic support of the Perich Group, and Karitane also provides individual extended child and is sustained in partnership with the generous support family health consults to assist families with parenting of South Western Sydney Local Health District challenges in the first 2,000 days. (SWSLHD). We are excited to be opening more hubs across The proximity of services to each other enhances NSW in the next 12 months, including in partnership Karitane Continuum of Care opportunities for formal and informal communication, with Gidget Foundation Australia and Stockland, Prevention Early Intervention Intensive Support collaboration and integrated care, to address and with philanthropic support in Shellharbour — the primary and community health needs of the which is part of the Illawarra Shoalhaven Local Oran Park community and surrounding areas. Health District (ISLHD). We will offer new parents Karitane at Oran Park provides nursing and allied early parenting support, toddler management, and health consultations that include comprehensive treatment of perinatal anxiety and depression as New Virtual interventions, such as counselling, problem-solving, part of an integrated, accessible care model. A Breastfeeding Clinic child growth and development, social support, further community hub, generously supported by parenting skills, and child-parent interactions, as well philanthropist and local business owner Mr John Breastfeeding is learnt over the first weeks and as the provision of resources including information Jones, will be opened in Shortland in the Hunter months of a child’s life. It is a unique and special and linking to other relevant services. As a result of New England Local Health District (HNELHD) experience for families, as no two mothers or babies the patient-focused team and co-location of other alongside other service providers. are the same. This year, Karitane launched the virtual services, interdisciplinary relationships have formed breastfeeding clinic, where lactation consultants, with other primary care providers, and clients midwives and child and family health nurses provide have benefitted from the increased collaboration breastfeeding support, using online consultations and — receiving a seamless continuum of care. 917 quality resources through the HelpMe Feed app. Families received individualised care This year we also launched an after-hours dad- through integrated care hubs The virtual breastfeeding clinic provides families with Integrated Care Hubs specific Circle of Security (COS) program at Oran support and exclusive access to resources through Karitane has been collaborating to develop and Park, in partnership with Anglicare. This program the app, allowing parents to chat to Karitane experts 100% deliver integrated, accessible, place-based services assists families with vulnerabilities, by providing and put together an individual plan to support the Agreed that staff treated them in local communities since early 2018. Our integrated mental health support, strategies to improve parent- breastfeeding journey. Karitane is the first Australian with respect care hubs (ICH) offer families early intervention child attachment and ways to increase a father’s adopter to use the HelpMe Feed app. and accessible and convenient care, and have understanding of his baby’s behaviour. demonstrated reduced admissions to more intensive 99% Benefits of the virtual breastfeeding clinic include: The demographics available for the Camden Council support, such as residential stays. Strongly agreed or agreed the advice Local Government Area (LGA), and particularly the • Easy Access: Parents book online for their one- they received was practical and hour consultation. Karitane’s first ICH launched with the innovative emerging suburbs which include Oran Park, show a large number of families with young children: 8.4% appropriate • Help on Demand: Supported whenever and Westfield Bondi Early Parenting Store in February compared to the Greater Sydney average of 6.4%. wherever parents are, from the convenience of a 2018 — the ultimate patient-centred care model, There is also growing evidence of family violence in 98% phone. Parents can message their Karitane expert attracting 7,250 parents during the year. This soft these emerging suburbs. A recent study by Sector Strongly agreed or agreed they were within the app and video consultations are also entry shopfront model is now also integrating and Connect Incorporated reported high numbers of involved in planning care and decision available. collaborating with teams from South Eastern Sydney Local Health District (SESLHD), child and family domestic and family violence, and discussed the making for their child • Short Video Resources: nurses, the Royal Hospital for Women’s genetic various factors for which this may be attributed, For every stage of the counselling team, midwifery, and the perinatal including the stress of isolation, mental health 97% breastfeeding journey. concerns, and workload. The dads COS program is mental health and health prevention team, to provide Strongly agreed or agreed that • Personalised Programs: integrated care along the first 2,000 days continuum. aimed at developing healthier relationships from the Clinically-approved, outset, which will have a lasting effect on the family information received met their needs simple and Karitane opened a further flagship ICH in the heart and community. secure. of South Western Sydney at Oran Park Podium in 99.9% October 2018, bringing the care and expertise of In late 2019, Karitane opened a third ICH funded by Overall satisfaction Karitane to the community. At Oran Park Podium, we Inner West Club grants, in partnership with Balmain Village Health and Loxley Health, to provide a unique
26 | Annual Report 2020 Karitane | 27 Parenting Centres & Virtual Home Visits “I highly recommend Karitane to any parent with small children! As a first-time mum there is so much conflicting information out there. Karitane offered me professional advice in a really supportive and friendly environment. The team was incredibly Karitane’s parenting centres and virtual home visits Virtual Home Visits welcoming, and they got to know my baby and the needs of our family and gave us offer flexible, targeted services to provide child and Virtual home visits are just like the one-on-one tailored advice for our personal situation. My son is now able to self-settle and is a family healthcare, parenting education, and support support parents would receive at one of our much better sleeper, all due to the techniques, strategies and support put together by for families with children aged 0-5 years. Karitane parenting centres, but are delivered to parents Karitane. Thank you Karitane. I couldn’t have done it without you!” helps improve the parent-child relationship and in their own home. Individual consultations are Parent supports parents in achieving their parenting goals up to two hours via video call with a Karitane for sleep and settling, feeding, establishing routines, child and family health nurse. toddler behaviour, and adjusting to parenting. The number of virtual home visits or parenting In addition to one-on-one care at the Randwick and centre consultations for each family depends Carramar parenting centres, group parent education on their individual needs. Our centralised intake courses are provided, including Big Baby Sleep, team matches the right service at the right time Women as Mothers and Circle of Security — plus an with the needs of each family, to develop an exclusive after-hours program for dads. ideal, personalised support plan.
In March 2020, Karitane hosted an Open Day at In response to COVID-19, all parenting centres Randwick Parenting Centre, attended by Mayor were temporarily offered through our virtual Danny Said and local healthcare providers, clinicians home visits to ensure parents, carers, children and partners. The event showcased the range of and families could still access support at a services and collaboration opportunities we provide. critical time. Karitane has offered virtual home visits since 2018 and was prepared to upscale Karitane also continued its partnership with the Red and train nurses within Karitane and other Cross Young Parents Program, providing parenting government and non-government organisations, workshops on sleep and settling, feeding and to deliver this critical service for the growing nutrition, and toddler behavior. demand during this challenging time.
This year, Karitane’s digital health hub Manager, Rebecca Gallagher, presented to the Australasian Institute of Digital Health (AIDH) — formerly known as Health Informatics Society of Australia — on the benefits of virtual services to reach families across Australia and successfully avoid patient admittance to more intensive services. Congratulations to Rebecca on her nomination for the Clinical Don Walker Award.
28 | Annual Report 2020 Karitane | 29 Supported Playgroup - Supported Playgroup Plus Community Programs Funding Partner: NSW Department of Communities and Justice Target Audience: Families with children birth - 5 years experiencing parenting difficulties, child behaviour, development, Supporting Families with Vulnerabilities nutrition and isolation challenges. Support: Weekly groups for 12 – 18 months, 8 playgroups offered, including 1 for families who identify as Aboriginal or Torres Strait Islander, and 1 in Vietnamese. Karitane provides a comprehensive range of Karitane works in partnership with the NSW Objective: This program* provides support, education and referrals specifically for parenting and child development community groups and programs delivering early Department of Communities and Justice, the issues. It helps to support and educate families on community services, reduce isolation, improve community networks and intervention and prevention, as well as family Department of Social Services, Mission Australia, build resilience.* Due to COVID-19, groups continued virtually to remain connected, reduce isolation and provide support. preservation and restoration programs to families and The Benevolent Society to deliver key community Families Supported in 2020: 64 families, 8 playgroups, 106 referrals received with vulnerabilities experiencing isolation, teenage programs that make a difference in families lives. Teenage Parents Peer Support - Talking Realities Program pregnancy, drug and alcohol issues, mental health Funding Partner: Department of Social Services conditions and family violence. Karitane also supports Target Audience: Young parents under the age of 24. families from culturally and linguistically diverse 1,218 Families Support: 26-week peer educator training course. Recognised pathway into TAFE NSW providing accreditation towards backgrounds, new migrant and refugee backgrounds this year 6 units of Certificate III in Community Services work. Offering face-to-face, phone and virtual support. and Aboriginal communities. Objective: 1) Increase knowledge, life skills and capacity to efficiently parent as a teenage parent. 2) Increase job capacity and tertiary education. 3) Provide education in schools about the ‘realities’ of teenage parenting as an adolescent New Transition to School, Parent Child Interaction Therapy (PCIT) pregnancy prevention program. A valuable opportunity for an interactive forum to talk about the challenges of parenting. Funding Partner: Mission Australia Due to COVID-19, school presentations were put on hold. Connection with young parents in the program continued via Target Audience: Families with children 2 - 5 years who are displaying behavioural challenges including: physical and Zoom, which was vital to reduce isolation. verbal aggression, non-compliance, over-activity, tantrums, destructive behaviour, hyperactivity, anxiety and withdrawal. Families Supported in 2020: 12 presentations at schools, 448 attendees, 149 case management meetings Support: PCIT is a 12-week program where trained therapists provide direct live coaching to parents during parent- Teen Parents in Custody - Family Matters Program child play sessions, to teach new skills aimed at improving the quality of the parent-child relationship, increasing positive behaviour and reducing negative behaviour in children. Funding Partner: NSW Department of Communities and Justice Objective: This is a new program launched this year. The PCIT Mission, Bringing Families Together, is offering Internet- Target Audience: Young women and men in custody. Adolescents who have experienced adverse family environments. PCIT (I-PCIT) to young children engaged in the innovative Transition to School program in the 2168 postcode. The Support: Group skills and individual consultations. Transition to School program is a collaboration of Ready Set Go and Sing and Grow where identified children preparing for Objective: Facilitate better outcomes for adolescent parents in custody and their children through: 1) Building positive school engage in an intensive support program. Children exhibiting more challenging behaviours during the program will parent-child relationships, ensuring child safety during visits and following the parent’s release. 2) Enhancing the parent’s also engage in I-PCIT. The model allows children to receive support and increase success for the school transition process. capacity to understand the needs of their child, reducing risk of a generational cycle of incarceration. 3) Increasing Families Supported in 2020: 16 families awareness in parents and staff of needs of children when visiting their parents in custody, and increasing understanding of Understanding the Emotions of Children’s Behaviours - Circle of Security (COS) healthy relationships. This year, Karitane Ambassador Steve ‘Commando’ Willis — as part of the Family Matters program — attended the Positive Role Model event at Reiby Youth Justice Centre. Steve spoke with the young men and women of Funding Partner: The Benevolent Society, Mission Australia the centre, sharing his own life story as a father of four and what makes a good role model. Target Audience: Families with children birth - 12 years. Families Supported in 2020: 435 participants, 171 programs Support: 8-week group skills program. Targeted Early Intervention Program Objective: This program* helps parents understand their child’s emotional world and learn to read the psychological need that lies beneath their child’s behaviour. Funding Partner: NSW Department of Communities and Justice Families Supported in 2020: 125 families, 11 groups (COS, TIK and WWWT combined) Target Audience: Families with vulnerabilities, with children birth - 5 years. Including families from culturally and linguistically diverse backgrounds, new migrant and refugee backgrounds. Emotion Coaching for Parents - Tuning into Kids (TIK) Support: Short-term early intervention (3 – 6 months). Parenting education, home visiting and referrals to appropriate Funding Partner: The Benevolent Society, Mission Australia services for parenting, child behaviour, development, nutrition, isolation, housing and financial, disabilities and family Target Audience: Families with children birth - 12 years. coping skills. Offering face-to-face, phone and virtual support. Support: 6-week group skills program. Objective: Prevent parenting challenges escalating into child protection concerns. Build family resilience, improve Objective: This parenting program* focuses on the emotional connection between parents and children. It teaches parenting confidence and reduce social isolation in communities. parents skills in emotion coaching to recognise, understand and respond to children’s needs in acceptive, supportive Families Supported in 2020: 65 families, 151 referrals received ways. This approach helps the child to understand and regulate their emotions. Volunteer In-Home Support - Volunteer Family Connect Families Supported in 2020: 125 families, 11 groups (COS, TIK and WWWT combined) Funding Partner: Private Donor First-Time Parent Education - What Were we Thinking? (WWWT) Target Audience: Families with vulnerabilities in the Liverpool, Fairfield, Bankstown and Macarthur LGAs, who have little Funding Partner: The Benevolent Society family support, multiple births or are migrants or refugees. Target Audience: First-time mums and dads. Support: Innovative program, matching volunteers with families for one-on-one support. Offering face-to-face, phone and Support: 8-hour workshop providing relevant information at the time parents need it most - when their baby is in their arms. virtual support. Objective: This innovative program* fills two gaps in current parenting education. 1) It demonstrates strategies to manage Objective: This program* increases parenting confidence and families’ connections to the community. We’ve partnered with baby crying, deal with settling difficulties and establish sustainable sleeping habits from an early age. Macquarie and Western Sydney Universities, The Benevolent Society, Save the Children and Focus on Families to research 2) It provides language and ideas to help parents adjust to changes in their relationship after the birth of their first baby. the effectiveness of mobilising communities with volunteer support services. Most extensive randomised control trial in the Families Supported in 2020: 125 families, 11 groups (COS, TIK and WWWT combined) world. This year VFC started online training for volunteers and supporting families through COVID-19 with virtual home visits. Families Supported in 2020: 65 families, 29 volunteers (Karitane and Focus on Families) * Content of the program is derived from evidence-based research.
30 | Annual Report 2020 Karitane | 31 We were referred to Karitane’s residential stay unit Intensive Support Virtual Residential Unit in Sydney — four full days of 24-hour support from The Karitane virtual residential unit provides an professionals. We were counting the days. But then Our Services innovative telehealth version of Karitane’s long- COVID-19 happened, and I got a call offering their standing multidisciplinary approach to child new virtual residential stay service: video calls on a and family health. The goal of the VRU model is private secure platform, phone calls, emails and texts, to emulate the inpatient residential experience which meant I could receive the same four days of of intensive parenting support, by enhancing support services, virtually, within the comfort of our Karitane Continuum of Care parenting practice and effectively facilitating early own home and within Jake’s own environment. intervention through partnership with parents. Prevention Early Intervention Intensive Support When I got the call advising that the residential Over four days, with up to three virtual home visits stay was going need to be administered virtually, a day and continuous support in the morning, I’ll admit it was a huge blow. Already running on afternoon, evening, and recently extended very little sleep and not having access to hands-on overnight services, families have the flexibility support, even from family, was really hard. Initially, we to access support when it suits their needs — had mixed feelings about the efficiency of a virtual Residential Stay & New Virtual Residential Unit enabling more partners to be involved in the service, asking ourselves if virtual support would be consultations. Karitane has provided inpatient residential services and Torres Strait Islander families at the Karitane as good as being face-to-face. Would it be effective since 1923, offering intensive and comprehensive residential service in Camden. The opening included Parents have access to our team of health in achieving the outcomes we wanted? support to families across NSW. Karitane health a traditional smoking ceremony, a welcome by professionals including GPs, paediatricians, However, we were immediately surprised and professionals work in partnership with each family Karitane’s Aboriginal Health Liaison Officer, Freda psychiatrists, psychologists and social workers, satisfied, as the nurses who worked with us were to support and guide parents through their identified Simpson, and a speech by Uncle Joe Dedeus of to support each family every step of the way. fantastic. We had access to two professional issues, working towards achieving their goals. the Strong Fathers Strong Families group. Karitane clinicians whenever we needed them, as if they is proud to be improving accessibility for Aboriginal The VRU aims to tailor the delivery of care This year, in response to the COVID-19 pandemic, were right there in our home. I was able to contact and Torres Strait Islander families seeking parenting to meet the specific needs of each family. Karitane developed and launched a new model of them when I needed them, by whatever means was support. Karitane works closely with the local The VRU collaborates closely with parents to care — the virtual residential unit (VRU). During available to me in that moment (by either video call, Aboriginal community and in the last year has identify goals, which are achievable through the peak of the pandemic in Sydney, all families text or phone call) and I would get an immediate provided support to over 356 families who identify modelling, anticipatory guidance and individual requiring the intensive residential service were response. There was no waiting time. as Aboriginal or Torres Strait Islander. and/or group parent education, utilising a offered this virtually. strengths-based approach. The service delivers They were so knowledgeable, caring and flexible. I specialist assessment of child development, In August 2019, Karitane celebrated the Indigenous felt completely comfortable ‘inviting’ the nurses into infant mental health and perinatal mental health. community by launching the Lil Possums Room, a my home, into my personal space, when we did the culturally welcoming, nurturing room for Aboriginal video calls. And for our morning meetings, it was always great to wake up to their friendly faces. I felt Debbie’s Story more like I was inviting them in for a cuppa and chat Virtual Residential Stay Client than a clinical, formal session. First-time mum Debbie was struggling to keep her Being able to implement what we learned with the six-month-old baby, Jake, asleep through the night. nurses, whilst having Jake in his own environment, He was up every few hours like clockwork, and as his own cot, his homely rituals before bed, was a real a result, Debbie was also running on minimal sleep. advantage. Having my nurses guide me through my Then COVID-19 hit. Isolation restrictions meant headphones, in trying to settle Jake (at any time of Debbie couldn’t receive help from her family, nurses the day or night) was amazing. They got to hear Jake or mothers groups at the time she needed it most. cry and told me when to pick him up and put him back down. “In the beginning in terms of sleep, Jake was fantastic. We thought we had a winner! But everyone I had a great experience and learnt so much. Jake is kept saying to us, wait until you reach the four- improving more and more every day and our family month mark — and that’s when it hit us. Jake was unit is adjusting so well to all the changes. If I can say up, screaming every one to two hours at night, and one positive thing about COVID-19 isolation, it is that nothing we tried was helping. it gave us the time to really invest in Jake’s sleeping pattern. If and when baby number two ever comes along, I know I’ll be ready!” 32 | Annual Report 2020 Karitane | 33 Perinatal Infant & Child briefer intervention models were offered, and by never had before. With my first baby I was tired the end of March the Karitane PICMHS team was and overwhelmed like all new parents, but this was Mental Health Service trained on the Pexip platform to provide 100% virtual different — I was at my limits. The psychologist Karitane provides a stepped care approach to service delivery. Parenting centre psychologists helped me unravel my feelings, gave me helpful mental health service provision for families with and residential unit allied health merged under the strategies, tips and resources, and built the mild to moderate mental health difficulties, ensuring PICMHS umbrella, and models of care were altered foundation in the right direction. each family receives the right level of treatment, at to meet the changing needs of families through the At the Karitane Parenting Centre, they helped me the right time. COVID-19 period. with my daughter’s sleeping. They gave me settling The perinatal period is a time of significant change Congratulations to the perinatal, infant and child techniques, helped me understand my baby’s tired for families. Postnatal depression and anxiety affects mental health (PICMH) team at Karitane. The team cues, wrapping my baby, her routine before bed, her 1 in 5 mums and 1 in 10 dads in Australia. Karitane has been highly commended in the category of cot set up, and even tips about room temperature. offers a secondary-level, specialist, early intervention Community Setting for its exceptional contribution in They gave me the support I needed for my journey outpatient perinatal infant mental health service to child protection and child wellbeing. The PICMH team to get better. I was looking after everyone else and support parents, infants and their extended families. works collaboratively with families and their networks putting myself last, if at all. I learnt I needed to look The perinatal period includes pregnancy and the within the community to improve parental mental after me, so I could take care of everyone else. year following birth. This service provides a space for health, increase parenting capacity and parenting Kelly’s Story With the support and guidance of Karitane and my families to seek treatment and enhance relationships skills and, in turn, contribute significantly towards I thought I needed help for my daughter, family and friends, I am back to my happy self again. in a caring environment during that time. improvement in children’s welfare and wellbeing, but I was the one struggling. But now I am even stronger and more confident in and reduction in child protection risk. The PICMH myself. I feel like I am a way better person. Going The service has a relational focus, with an emphasis service uses outcome tools to measure improvement “I went to Karitane for breastfeeding and sleep and through it was awful; I felt weak, guilty, lonely and on supporting the quality of the relationship between in mental health, as well as parenting confidence and settling issues with my second baby. I was struggling hopeless. But to be honest, the more I open up about parents and their infant. Families are offered a client satisfaction in the services received. This helps the second time around, as my three-month old it, the more I hear other mums and dads with similar combination of individual, family and parent-infant with continuing to improve our services and to meet daughter wouldn’t sleep, my recovery was slow stories. It’s actually more common than we think, psychotherapy. Families work in partnership with the changing needs of families. and painful, and I could feel myself crumbling under our multidisciplinary team, including our clinical the pressure. I was in Westfield Bondi Junction and and it’s OK. It’s hard being a parent sometimes, and psychologists, social workers, mental health nurses, actually walked past the Karitane Early Parenting it is OK to ask for help, go to Karitane, or speak to a perinatal infant and child psychiatrists, and child and Store. I am so glad I did, because without them my friend. You are not alone.” family health nurses. Families are usually engaged journey would have been very different. in psychotherapeutic treatment programs for several As soon as I entered, I felt immediately cared for months, in line with their mental health diagnosis. and looked after. But what I didn’t expect was In November 2019, Karitane held PANDA-Monium, that although I went in for help with my baby, it an event for Perinatal Anxiety & Depression Australia was actually me who needed the help. In my initial (PANDA) Week and Movember, thanks to a successful consultation they asked me an array of questions grant from Camden RSL. This event raised awareness about my wellbeing. I was having sleepless nights, for postnatal anxiety and depression, offering support my son had just started school, and my husband had to men, women and families in the South Eastern started a new job, so was working long hours. I was Sydney Local Health District. The successful event trying to hold it all together and I was overwhelmed included keynote speakers, activities for children, — silently and slowly suffering. It was scary. The interactive sessions for families, and dinner. Karitane nurse asked if I would be interested in having some sessions with their psychologist at The perinatal infant mental health pre-therapy the Karitane Parenting Centre in Randwick, free of group continues as a strategy to manage increasing charge. I said yes! I had no idea these services were demand, and to support parents waiting for more provided for parents for free — and why hadn’t I ever intensive interventions. Psychoeducation is provided heard of this? by clinicians, with strategies to support parents’ mental health over a five-week face-to-face course. The psychologist was warm, welcoming, supportive and amazing! Having someone to talk was priceless; In response to COVID-19, families referred to our someone to talk to about you and your baby. perinatal infant and child mental health service Everyone asks about your baby, but they don’t (PICMHS) were delivered treatment through telehealth ask about you. I was diagnosed with postnatal modes (both video and telephone). Long-term and depression, and depression is something I have
34 | Annual Report 2020 Karitane | 35 Toddler Clinic & Parent The Value of Internet-Parent Child Interaction Therapy Internet-PCIT Child Interaction Therapy The evidence-base for PCIT is extensive IMPACT NEED VALUE I-PCIT has been proven to I-PCIT breaks down barriers I-PCIT is cost effective Established in 2006, the Karitane Toddler Clinic is a (Ward et al. 2016), yet various barriers have change the trajectory of a providing children and their with up to A$22.30 social specialised service offering Parent Child Interaction impeded widespread dissemination of the child’s life and improve families access to effective value returned for every parent and family wellbeing. treatment within their home. $1 invested. Therapy (PCIT) — an evidence-based method program across Australia, especially to rural of treating disruptive behaviour in children aged and remote areas. In particular, stringent two to four years. The aim of PCIT is to improve therapist training requirements and reliance on Benefits of I-PCIT a child’s behaviour, by strengthening the parent- specialist equipment (one-way mirrors, wireless Reduced disruptive behaviour problems in children 2-5 Treatment effects extend to the home and school settings child relationship and teaching positive limit setting communication systems) has meant that Reduced psychological distress in parents Skills generalise to untreated siblings strategies over a 12-week period. Helping to mitigate delivery of PCIT is costly and challenging for Improved parenting skills and confidence behaviour problems early is key to improving family many community-based mental health clinics dynamics and preventing chronic problems emerging — particularly those in regional and remote Benefits of I-PCIT continue to compound over time later in life. areas which are typically under-resourced. Fortunately, PCIT is particularly amenable to The Karitane toddler clinic is recognised by PCIT internet-based delivery, given its use of live International as the leading Australian PCIT provider coaching using a one way-mirror and bug- and training organisation. The Karitane toddler clinic in-the-ear microphone, which can be easily is supported by Australia’s only PCIT International- replaced with a video-conferencing screen and Child School Parents Sibling Family Adolescents Adult Certified Level 2 Trainer, Sue Morgan, who was Bluetooth microphone and earpiece. In recent awarded the prestigious PCIT International Research years, the adaptation of the PCIT model from Benefits of treatment Effect score and Innovation Award this year, and has been invited an ‘in-clinic’ to ‘telehealth’ model has gained maintained to apply for Global Trainer status. Sue will also be the momentum and a growing evidence-base 70% 50% 1.72 Chairperson for the PCIT International Development (Fleming et al. 2018; Comer et al. 2017). +6 years (2.5 x more effective Taskforce — a highly prestigious appointment — than medication) I-PCIT allows clinicians to use the same ‘live representing 148 PCIT International-Certified therapists Of children showed No longer are more effective in this role. coaching’ method offered to families in-person positive treatment met criteria for a disruptive Just at the Karitane toddler clinic. In I-PCIT, the response behaviour disorder 4 sessions than medication The Karitane toddler clinic has also been a leader in the family is located in their own home or a rural development of PCIT adaptations to meet the unique clinic, and the Sydney-based PCIT clinician needs of specific populations, including Internet-Parent coaches the parent using video conferencing Child Interaction Therapy (I-PCIT), and PCIT with and Bluetooth headset technology. After the toddlers (PCIT-T), an adaptation designed to meet the successful completion of a pilot program and unique needs of children aged less than two years. evidence of positive clinical outcomes, our Australian children between two and seven years displaying high academic lead Dr Jane Kohlhoff and her team PCIT-T was evaluated in a sample of 66 parent-child levels of disruptive behaviour scaled up the program, treating families across dyads, using a randomised controlled design. Results NSW since January 2019. showed that compared to non-treated controls, families who received PCIT-T displayed significantly greater I-PCIT Untreated reductions in the severity of disruptive child behaviours clinic behaviour interventions through these challenging and greater increases in parental skills and sensitivity. International best practice times. This included phone support and four-week Effective early intervention psychoeducational groups delivered virtually. Evidence-based, rigorously tested +40 years Trajectory towards poor psychological, The Karitane toddler clinic is recognised as a centre Parent training-based behaviour therapy “We were shocked because psychiatric and social outcomes of excellence across Australia as a PCIT training The launch of toddler behaviour virtual groups Reaches rural and regional families there was just no aggression across the lifespan clinic, with postgraduate intern psychologists regularly Karitane +10 years leaders of practice and training anymore. It was amazing, like has been successful with 100% retention rates, in Australia a miracle. It has helped in so completing university placements to learn about the caregivers attending together, and positive feedback many ways.” PCIT and I-PCIT models. This year, Karitane trained a Insecure attachments from participants who expressed the support they Negative parent-child relationship cohort of 10 new PCIT therapists across NSW. “The results were immediate. Increased rates of internalising and received provided them with the strategies they Strong and positive parent-child relationship I’ve got new skills that I can externalising behaviour difficulties Secure attachment to primary caregiver needed and they no longer required the more use in situations rather than Lower social competence In response to COVID-19 in April, the toddler clinic Strong social skills development intense PCIT program. not knowing what to do.” Increased adolescent mental health started offering a broader range of interventions to PCIT Positive behavioural trajectories difficulties and I-PCIT, to ensure families had access to toddler Healthy emotion regulation Resilience “He’s a completely different child, just so much calmer. Reduced psychopathology We have a much closer relationship now.”
36 | Annual Report 2020 Karitane | 37 Celebrating Dads
Karitane believes in a whole family approach, and the working with fathers toolkit, which provides an absolute importance of a partner or father-inclusive informed framework for working with dads. practice. We continue to focus on reaching and Within our residential service, dads and partners engaging with more dads, to support families on their have full access to our multidisciplinary team, parenting journey. which includes a weekly father and partner group. While the majority of dads take leave after the birth Facilitated by a psychologist or social worker, this of a child, it is generally relatively short. According group provides an opportunity for partners to talk to the Australian Bureau of Statistics, 70% of the about their experiences of parenthood. Topics Aussie dads who took parental leave were back at include your partner or dad role and what it means work within two weeks. 1 in 10 dads experience to you, high expectations placed on dads by modern separation anxiety or depression. Parents may society, ways to further enhance the relationship also be supporting their partner with mental health between dads and children, and how to support your New Karitane Ambassador Being a dad to me is about showing love and conditions, lack of sleep, or feeding issues with partner. In addition to our weekly father and partner Steve ‘Commando’ Willis affection. I’m always giving my kids hugs and the baby. group, we offer an after-hours Circle of Security kisses and telling how much I love them. I feel that’s course specifically for dads at our parenting centre in This year we are so excited to announce Steve This year we launched five new pages on our website something I lacked from an early age and it definitely Randwick — which has proved highly successful. ‘Commando’ Willis as a new ambassador for dedicated exclusively to dads: Becoming a Dad, Karitane. His honesty and passion about his role as a had an impact on the more intimate aspects of my Dads Make a Difference, My Relationships, Work-Life For Father’s Day 2019, we celebrated dads in dad and the importance of connection and wellbeing own life. That nurture and love is so important, but Balance, and Wellbeing and Mental Health. We also partnership with Dads Inc. — hosting Man with is aligned with our purpose of enhancing parent-child so is staying calm, being present in the moment and relaunched our parenting brochures, adding specific a Pram, where new dads, mums, grandparents relationships, building parent capacity, advocating listening — really listening. It’s about not pretending pages for dads in regard to adjusting to parenting, and friends created ‘the village that raises a child’. for and supporting families and young children, and to have all the answers, saying ‘I just don’t know’. wellbeing and parenting today. Families gathered at our integrated care hub Early strengthening a family’s connection with supports It’s about reflecting and apologising if I have reacted Parenting Store in Westfield Bondi Junction. From inside their community. or responded in way that I’m not happy with. I’m not One of the most significant aspects of our there, dads pushed their infants and children in their perfect and we all make mistakes, but when I do, I try practical parenting support in the workplace, prams and socialised with others from the area. We Steve is passionate about the importance of to talk to my kids about it. is the opportunity for dads and partners to seek finished the walk back at the Karitane Early Parenting balancing his career with being present with his information and support. This provides a platform I’m 44 now and I am still learning. It’s very much Store with a few activities, and a space for parents to children. He is the embodiment of today’s modern for dads to seek information that is relevant to their like exercise and fitness. You can throw yourself at connect with other families and enjoy morning tea. It working dad who also appreciates the rewarding, and parenting journey, while allowing an opportunity a physical challenge, and slowly over time you start was a celebration of new life with the arrival of new at times challenging, journey of being a parent. We for them to ask questions and connect with other to build on it and before you know it, it’s part of who babies into our communities, and also championed are really looking forward to building this long-term parents in their workplace. you are. It’s exactly the same as being a parent. the importance of active fatherhood. This was a great partnership with Steve, where he can assist us to You’re not going to have all the answers. Every day it opportunity for dads to connect with other new raise awareness and visibility — sharing the message Karitane hosted Dominic Alford from Relationships is about making a choice to be the parent you want dads, spend time with their kids and most of all, help of the role of dads, the importance of their emotional Australia to present the Support for Fathers to be. That is why I want to work with Karitane. Their inspire and connect dads at this important stage of connection with their children, balancing a career workshop. This workshop saw the launch of the purpose is to help and support parents and provide their lives. with parenting, and not being afraid to seek support. At Karitane, we celebrate the evolving role of dads in practical parenting strategies, so people can see the today’s society. With Steve, we hope to reach more beauty in life and enjoy being a parent. Karitane are dads in our communities and support them to be the experts.” dad they want to be. Steve Willis joins our long-time patron Ita Buttrose, “When I first became a parent at 22, I was still young who has been involved with Karitane since 2013. and very much about myself. Now I have four children and the dad I am today is worlds apart from what I was like back then. But what I always knew was that I wanted to do things differently to how I’d been parented. When I was growing up there was a lot of tension and anger in my house.
38 | Annual Report 2020 Karitane | 39 Clinical Research & Evidence Base
Research and education underpin the delivery of access specialised treatment for childhood disruptive all of our clinical care. We lead the creation and behaviours, irrespective of their geographical dissemination of the latest evidence-based research, location. always ensuring we provide the most trusted advice The program was shown to be feasible, acceptable to parents, and uphold excellence in the education of to families, and clinically successful. In 2019-2020, health professionals, staff, students and academia. Karitane disseminated results from this pilot work, In the last 12 months, Karitane has continued publishing results in three journal articles (Rural and its perinatal and infant mental health academic Remote Health, Clinical Psychologist, and Behavior partnership with the University of New South Therapy) and presenting at three conferences (the Wales (UNSW) School of Psychiatry. The aim of PCIT International Biennial Convention in Chicago, the partnership is to develop a perinatal and infant the MCaFHNA Conference in Sydney, and the Health mental health research program at Karitane, provide Informatics Conference in Melbourne). leadership for the development of perinatal and In recognition of this important work, the Karitane infant mental health services within Karitane, and I-PCIT program was awarded a Highly Commended contribute to UNSW undergraduate and postgraduate prize at the 2019 ACHS Quality Improvement Awards, training and supervision of higher degree research in the category Clinical Excellence and Patient Safety. students. Karitane has now signed a further five- year agreement with UNSW to extend the formal collaboration and continue our successful 2. PCIT-Toddler Research partnership work. From 2014-2017, Dr Jane Kohlhoff and Sue Morgan developed an early intervention program for children The Karitane research department is led by Dr with disruptive behaviours aged 12 to 24 months, Jane Kohlhoff. In 2019-2020, Dr Kohlhoff was called Parent Child Interaction Therapy – Toddler supported by a team of researchers, including Dr (PCIT-T). They conducted a randomised controlled Nancy Wallace (UNSW Postdoctoral Fellow), Sara trial (RCT) to evaluate the effectiveness of the Cibralic (UNSW Research Assistant) and Sue Morgan program. (Karitane Clinical Nurse Consultant). The team also collaborated widely with researchers and clinicians The program was found to be associated with 3. Volunteer Family Connect to provide social and practical support to families significant benefits for families including improved from across Australia and internationally. At the end of 2012, a collaborative relationship was with children under five years of age. Trained toddler behaviour, improved parenting sensitivity and formed between researchers and three leading volunteers visit families in their homes or another safe The team has experienced significant successes positive parental evaluation of the program. A major Australian non-government organisations — Good place, on a weekly basis for up to two hours, for three from July 2019 to June 2020, with 15 publications highlight of the past 12 months was the publication Beginnings Australia (now part of Save the Children), to 12 months. The volunteer works in partnership accepted or published in peer-reviewed journals of three peer-reviewed journal articles reporting The Benevolent Society and Karitane. This group with the family to offer information, friendly support and nine international and national conference results from the research, published in the Journal came together to conduct rigorous research that and encouragement in a non-threatening, non- presentations. of Clinical Child & Adolescent Psychology, Clinical would answer questions about the extent to which directive, non-judgemental manner. VFC is intended Psychologist and Infant Mental Health Journal. The volunteer home visiting programs were effective to complement and work in conjunction with research received significant interest from the media, in supporting: professional services — providing a community- Highlights leading to appearances by lead author Dr Jane based early intervention model that focuses on the Kohlhoff on ABC radio, Channel 10 and the Feed • Positive outcomes for families, importance of parent-child bonding and creating 1. Internet-PCIT Research Play Love podcast. • Positive outcomes for the volunteers who delivered bridges between families and their local communities. Karitane has been the lead developer and provider In 2018, Dr Kohlhoff and Ms Morgan collaborated the service, and of Internet-PCIT (I-PCIT) in Australia. With a NSW This year VFC had three major new initiatives: online with international colleagues to develop a formal • A significant social return on investment. Health Mental Health Innovations Grant awarded in training modules for volunteers, support for families treatment model (Girard et al. 2018). Throughout The collaboration conducted a randomised controlled 2018, Karitane developed and pilot-tested a world delivered virtually, and the development of a volunteer 2019-2020, a second RCT was conducted at trial of volunteer home visiting. first community-based I-PCIT service, which enabled Volunteer Family support package that can be applied to other the Karitane toddler clinic to further evaluate the families from rural and remote areas of NSW to Connect (VFC) is an evidence-based program, volunteer groups. (E.g. Aged care and disability.) effectiveness of the PCIT-T program. combining current best practice and clinical expertise
40 | Annual Report 2020 Karitane | 41 Research Collaborations Active Research Grants Higher Degree Research & Partnerships • S. Tooke, J. Kohlhoff. The Pre-admission Midwife Students Appointment Program at the Mater: A qualitative Karitane has continued to be a partner on a number • Sara Cibralic, UNSW PhD candidate investigation of consumer satisfaction and impact. of major research initiatives throughout 2019-2020, project title: “The impact of PCIT-T on parental Friends of the Mater Foundation grant (2019-2020). including the Early Life Determinants of Health emotion regulation, reflective functioning, and (ELDoH) Clinical Academic Group within the Sydney • V. Eapen, R. Lingam, J. Whitehall, S. Raman, L. understanding of the role of emotions in parenting Partnership for Health, Education, Research and Kemp, A. George, A. Page, B. Jalaludi, S. Teng- and toddler behaviour.” Enterprise (SPHERE) and the System Transformation Liaw, S. Woolfenden, J. Kohlhoff, E. De Leeuw, Supervisors: Dr Jane Kohlhoff, Prof V. Eapen, and Research Translation - South Western Sydney J. Baker. System Transformation and Research A/Prof C. McMahon Translation – South Western Sydney. (BestSTART- (BestSTART-SWS) academic unit for child health • Michelle Kenny, UNSW PhD candidate SWS) South Western Sydney Local Health District research. project title: “Evaluating the effectiveness of Academic Unit. Enhancement of an Academic Unit a trauma informed parenting intervention for Karitane continues to be a member of the SWS (2018-2022). Indigenous parents’ mental health and attachment Research Hub, with Karitane CEO Grainne O’Loughlin • J. Kohlhoff. The neurobiology of parenting and quality.” sitting as a member of the South West Sydney Disruptive Behaviour Disorder subtypes in early Supervisors: Dr Jane Kohlhoff, Prof V. Eapen, Research (SWSR) Executive Committee and childhood. Australian Research Council Discovery Dr Beth Mah, A/Prof Kym Rae serving as ambassador for the SPHERE Knowledge Early Career Researcher Award (DE170100413; Translation Committee. We also partner with the • Maddie Simpson, WSU PhD candidate 2017-2021). UNSW and WSU academic units, including the newly project title: “Understanding the development of established Transforming Early Education and post-traumatic stress disorder following childbirth Child Health (TeEACH) in the Translational Health and its impact on women who access residential Research Institute. Awards and day parenting services in NSW.” Supervisors: Prof Hannah Dahlen, We were delighted to formally renew Dr Jane Highly Commended, 2019 Australian Council Virginia Schmied, Cathy Dickson Kohlhoff’s conjoint academic appointment with the on Healthcare Standards (ACHS) Quality • Bryan Neo, UNSW Masters candidate UNSW Department of Medicine School of Psychiatry Improvement Awards. Category: Clinical project title: “Validation of the Clinical Assessment for a further five years. Excellence and Patient Safety. of Prosocial Emotions (CAPE) in Preschoolers with Karitane also partners with a number of health, Disruptive Behaviour.” community and university-based organisations to Supervisors/Co-investigators: A/Prof Eva Kimonis conduct specific translational research projects, (UNSW), A/Prof David Hawes (USyd), Prof V. Eapen including projects focused on refugee health, home Current Research Projects (UNSW) visiting for CALD families, postnatal depression, • The 'Watch Me Grow’ App for identification of infant-directed speech, and PCIT. Partners include: developmental and mental health problems in early childhood: a validation study. • University of New South Wales Investigators: Kohlhoff, J., Eapen, V. Research Outputs • Western Sydney University • Neurobiology of parenting and disruptive behaviour July 2019 - June 2020 • University of Sydney disorders in childhood. • Newcastle University Investigators: Kohlhoff, J., Hawes, D., Eapen, V. Peer-Reviewed Journal Articles • Macquarie University • A Randomised Controlled Trial comparing 1. Bennett, E., Simpson, W., Fowler, C., Munns, A., Kohlhoff, J. (2020). Enhancing access to parenting • West Virginia University PCIT-T, COS-P and Waitlist controls in the treatment of disruptive behaviours in children a services using digital technology supported • MARCS Institute ged 14-24 months. practices. Australian Journal of Child and Family • Parenting Research Centre Investigators: Kohlhoff, J., McNeil, S., McMahon, Health Nursing 2020; 17(1):4-11. • Gidget Foundation Australia C., Morgan, S., Huber, A., Hawkins, E., Eapen, V. 2. Wu, Y., Levis, B., Loannidis, J.P.A., Benedetti, A., • Mater Hospital Thombs, B.T., & the DEPRESsion Screening Data • South Western Sydney Local Health District (DEPRESSD) Collaboration (2020). Probability of Major Depression Classification Based on • South Eastern Sydney Local Health District the SCID, CIDI and MINI Diagnostic Interviews: • Mid North Coast Local Health District A Synthesis of Three Individual Participant • Western NSW Local Health District
42 | Annual Report 2020 Karitane | 43 Data Meta-Analyses. Psychotherapy and 11. Kohlhoff, J., Morgan, S., Briggs, N., Egan, R., 2. J. Kohlhoff & S. Morgan. Parent-Child Interaction “The knowledge and support we have Psychosomatics, 129, 109892. Niec, L. (2020). Parent-Child Interaction Therapy Therapy for Toddlers (PCIT-T): Evaluation of received has been fantastic. We had strategies 3. Thombs, B.D., Levis, B.,….Kohlhoff, J. et al. (In with Toddlers: A community-based randomized an attachment-based parenting program. Oral to get us through this rough patch of night Press). Overestimation of Postpartum Depression controlled trial with children aged 14-24 months. Presentation to the Australian Association terrors, many of which filtered through to my Prevalence Based on the EPDS-5 as Used in the Journal of Clinical Child and Adolescent for Infant Mental Health (AAIMH). Adelaide, daughter’s daytime routine. My daughter is Psychology. https://doi.org/10.1080/15374416.20 September 2019. Maternal Mental Health in Canada, 2018/2019 now back to her settled evening routine and 20.1723599. Survey: Systematic Review and Individual 3. N. Wallace, E. Girard, J. Kohlhoff, S. Morgan, generally only wakes once or twice for a nappy Participant Data Meta-Analysis. The Canadian 12. Kohlhoff, J., Cibralic, S., Horswood, D., Turnell, C. McNeil. Getting in Early: Treating Toddlers’ change. We still experience night terrors Journal of Psychiatry, accepted 7.5.20. A., Maiulo, M., Morgan, S. (2020). Feasibility and Unique Emotion Regulation Needs using a PCIT every few weeks or so, but as the frequency Acceptability of Internet-Delivered Parent-Child framework. Oral presentation at the 2019 PCIT 4. Kohlhoff, J., Lee, S., Cibralic, S., Jones, P., and duration has decreased dramatically, it Interaction Therapy (I-PCIT) for Rural Australian International Biennial Convention, Chicago, Khajehei, M. (In Press). Development and is all much more manageable. The support Validation of the Karitane Family Outcomes Families: A Qualitative Investigation. Rural August 2019. I received was much needed and delivered Tool (KFOT). Journal for Specialists in Pediatric and Remote Health, 20 (1), 5306. https://doi. 4. S. Morgan, G. Fleming, J. Kohlhoff. Internet- with genuine compassion, empathy and Nursing, accepted 4.5.20. org/10.22605/RRH5306. PCIT in Australia. Oral presentation at the 2019 respect. We are both much better rested 5. Fleming, G.E., Kohlhoff, J., Morgan, S., Turnell, 13. Levis, B., McMillan, D., Sun, Y., Kohlhoff, J. PCIT International Biennial Convention, Chicago, and thriving. I highly recommend Karitane for A., Maiuolo, M., Kimonis, E.R. (In Press). An et al. (2019). Comparison of major depression August 2019. anyone needing some professional guidance effectiveness open trial of Internet-delivered diagnostic classification probability using the 5. N. Wallace, E. Girard, J. Kohlhoff, S. Morgan, parent training for young children with conduct SCID, CIDI and MINI diagnostic interviews among C. McNeil. Pulling Apart PCIT-T: A Theoretical or support with their little one.” problems living in regional and rural Australia. women in pregnancy or postpartum: An individual and Practical Application of Infusing Emotional Parent Behavior Therapy, accepted 9.3.20. participant data meta-analysis. International Intelligence Techniques into Early Intervention Journal of Methods in Psychiatric Research, 6. Kohlhoff, J., Cibralic, S., Morgan, S. (2020). A with Toddlers. Oral presentation at the 2019 e1803. https://doi.org/10.1002/mpr.1803. qualitative investigation of consumer experiences PCIT International Biennial Convention, Chicago, of the Child Directed Interaction Phase of parent- 14. Kohlhoff, J., Cibralic, S., Lennie, L., Rabetts, August 2019. child interaction therapy with toddlers. Clinical L., Morgan, S. (2019). Qualitative Evaluation 6. C. Lieneman, J. Kohlhoff, S. Cibralic, S. Morgan, Psychologist, accepted 2.3.20. DOI:10.1111/ of Australian Caregiver’s Experiences of N. Wallace, C. McNeil. Poster presentation at cp.12216. Parent-Child Interaction Therapy delivered in the 2019 PCIT International Biennial Convention, a Community-Based Clinic setting. Australian 7. Kohlhoff, J., Morgan, S., Briggs, N., Egan, R., Chicago, August 2019. Psychologist, 1-14. https://doi.org/10.1111/ Niec, L. (In Press). Parent-Child Interaction 7. J. Kohlhoff. Using technology to improve access ap.12431. Therapy with Toddlers in a community-based to early parenting services: A case study of setting: Improvements in emotional availability, 15. Cibralic, S., Kohlhoff, J., Wallace, N., McMahon, Internet delivered ‘Parent-child interaction child behaviour and attachment. Infant Mental C., Eapen, V. (2019). A systematic review of therapy’. Poster presentation at the Health Health Journal, accepted 5.3.20. emotion regulation in toddlers and preschoolers Informatics Conference 2019. Melbourne, August with Autism Spectrum Disorder. Research in 8. Baker, J.R., Kohlhoff, J., Se-Inyenede 2019. Autism Spectrum Disorders, 68, 101422. https:// Onobrakpor, S., Woolfenden, S., Knebel, C., 8. J. Kohlhoff, S. Lee, P. Jones, M. Khajehei. The doi.org/10.1016/j.rasd.2019.101422. Smith, R., Eapen, V. (In Press). A Rapid Review Karitane Family Outcomes Tool (KFOT): A new of the Feasibility and Efficacy of Web-based Report scale to assess outcomes of Early Parenting Developmental Surveillance Programs. Submitted Centre interventions. Poster presented at the 1. Fowler, C., Bennett, E., Simpson, W., Munns, to JMIR mHealth and uHealth, accepted 11.2.20. Maternal, Child and Family Health Nurses A. & Kohlhoff, J. (2020). Enhancing access to Australia (MCaFHNA) conference. Sydney, 9. McInnis, P., Kohlhoff, J., Eapen, V. (2020). Real- parenting services through the use of digital August 2019. world outcomes of PCIT for children at risk of technology supported practices: Research autism or developmental delay. Journal of Child Report, AAPCH: Canberra. 9. J. Kohlhoff, D. Davis, J. Cormick, G. Fleming, and Family Studies. Accepted 5.2.20. E. Kimonis. Internet-delivered Parent Child 10. Kohlhoff, J., Mahmood, D., Kimonis, E., Hawes, Conference Presentations Interaction Therapy (I-PCIT): Partnering with D., Morgan, S., Egan, R., Niec, L., Eapen, 1. S. Morgan & J. Kohlhoff. Parent-Child Interaction NSW Child and Family Health Nurses to V. (2020). Callous-unemotional traits and Therapy for Toddlers (PCIT-T): An attachment- improve accessibility to parenting services for disorganized attachment: Links with disruptive based parenting program for young children with rural, regional and remote families of children behaviors in toddlers, Child Psychiatry and disruptive behaviours. Oral Presentation to the with disruptive behaviour. Oral presentation at Human Development. doi: 10.1007/s10578-019- Australasian MARCE society conference (AAIMH). the Maternal, Child and Family Health Nurses 00951-z. Perth, October 2019. Australia (MCaFHNA) conference. Sydney, August 2019.
44 | Annual Report 2020 Karitane | 45 Governance, Safety, Quality & Outcomes
Karitane has a robust governance framework programs, with more groups to support families underpinning the delivery of high-quality evidence- attending residential and outpatient services, more based healthcare in a safe, efficient and transparent blended virtual and face-to-face models of care, operating environment. This framework ensures and, for new clients, a more informative orientation operational compliance with national and state to services. In addition to this, our consumers have legislation and NSW Health policies across all helped us review key communications and website Karitane sites and services. design to ensure it is clear, succinct, and meets the needs of the families we support. In 2020, Karitane has continued to promote a culture of safety and quality for both visitors and staff. Clinical Outcomes & Client Feedback Through incident and risk management, hazard The use of both consumer feedback and client- identification, and continuous quality improvement, reported outcome measures has been a key focus Karitane has consistently achieved excellent results for further development this year. As the government in all external audits, performing with high levels and service system shift to value-based healthcare of compliance across ACHS accreditation, work and outcomes-based funding models, Karitane health and safety, and security. External auditors is at the forefront of ensuring each service has a have independently highlighted Karitane’s good consistent framework for evaluating both client governance, strong leadership and transparent satisfaction and care outcomes. communication sitting at the centre of our outstanding results, and we have been commended In addition to our new client satisfaction survey tool, for our positive workplace culture and noticeable Karitane has introduced a new outcomes assessment adherence to our values of respect, innovation, framework. This framework has been developed collaboration and excellence. to ensure outcome measures are in place to effectively evaluate models of care and patient attending residential early parenting centres (EPCs) in Consumer Engagement journeys. Results to date have been positive, with Australia. Published research in 2020 conducted by Karitane has continued to engage consumers across high rates of client satisfaction and significant the team (Journal for Specialists in Pediatric Nursing) Parent-Reported all services to increase collaborative decision-making changes in patient-reported outcomes across has demonstrated the tool is a brief, valid and Outcomes and improve access and equity in service provision. knowledge, skills and confidence. reliable parent-report scale for early parenting centre Through increased consumer representation, Karitane outcomes evaluation. Use of this tool across Karitane 99% Our outcomes focus has also seen the expansion continues to plan new initiatives and refine existing EPCs will assist in further enhancements to clinical Client satisfaction of our digital screening program. Digital screening service delivery to better meet the needs of the care at Karitane. for perinatal mental health risk factors was first families we support. introduced for inpatient services at Karitane in 2019, Parenting Self-Efficacy 98% Our enhanced 2020 Consumer and Community and has since been extended to screen parents in Of clients found Karitane services helpful Participation Framework defines how the organisation outpatient settings as well. In partnership with the seeks to engage consumers at all levels of decision- Centre of Perinatal Excellence (COPE), Karitane Virtual Home Virtual 98% making within Karitane, and provides families with has continued to prioritise universal screening Visits Residential Unit Parents reported their knowledge the confidence of knowing the feedback they provide as a starting point for partnering with parents had improved will shape service delivery. Additionally, our newly in care planning — ensuring interventions are launched Consumer Advisory Group will ensure input targeted, holistic and aligned with client goals. The 81% 84% accurately reflects the needs of the communities we development of the Karitane family outcomes tool 97% Parents believed staff had the skills serve through consultation with our families, partners (KFOT) has further progressed Karitane’s leadership and stakeholders. in outcomes-based evaluation. The KFOT was Of families reported Of families reported and knowledge to help them positive change positive change developed by the research team at Karitane to +75 net promoter score This year, our consumer engagement and co-design provide a culturally appropriate tool to measure the focus has brought positive changes to numerous effectiveness of the interventions provided to parents May snapshot July 1st to June 30, 2020
46 | Annual Report 2020 Karitane | 47 People & Culture
Karitane is a dynamic, family-friendly workplace with a culture that reflects our values of innovation, Benchmarking Performance Against Primary Partners excellence, respect and collaboration. We are Karitane has a committed to inclusion and wellbeing so our people Karitane compared with the norms for No. of questions rated ‘Above the Norm’ = 132 can thrive, and so we can provide the best, most culture of success! health and community services No. of questions rated ‘Near the Norm’ = 6 effective care to families. No. of questions rated ‘Below the Norm’ = 4
Our people and culture focus has emphasised 77% Engaging our People 1 32 a number of initiatives this year: Of staff participated in the survey Identity & Direction 18
• Staff cultural survey Values -1 2 12 • Staff wellbeing 95% Risk at Work 6 • Working flexibly Of staff felt they made a valuable Leadership Landscape -2 1 26 • Helping staff adjust to working from home through contribution to their field of work Organisational Change -1 2 25 COVID-19 Client Engagement 13 • Training and professional development • Workforce capacity building, including leadership 89% development Of staff felt treated with respect by their manager clinical staff across the organisation. The clinical Master of Child & Family Health (Karitane) development and support team meets weekly to Organisational Culture Karitane and Western Sydney University (WSU) held discuss the emerging clinical support needs of the Best Practice Australia Survey a workshop with key stakeholders in child and family organisation. This ensures clinical practice remains of health to review the Master of Child and Family This year, Karitane engaged Best Practice Australia Between 86-89% the highest standard and the education and support Health course. This was an important opportunity, to complete an organisation engagement survey to Of staff felt that their manager needs of staff are met in a timely way. This year also to ensure the course reflected the current practice understand our organisational culture and strengths displayed values in action for saw the introduction of a multidisciplinary clinical needs of child and family health professionals. and develop strategies for any identified areas of collaboration, innovation and development and support meeting which enables opportunity. excellence all clinical disciplines to contribute to education A significant decision was made to include a perinatal and support. mental health unit into the graduate certificate The survey revealed excellent workforce engagement, component, where previously students only received inclusion and diversity, values in action, leadership, this if completing the graduate diploma. Perinatal change management, and client experience, with all Education for Healthcare Professionals mental health skills are a significant component of out-performing industry benchmarks! Karitane offers professional development and training child and family health practice, therefore it was to healthcare professionals, including nannies, essential it be included. Karitane has completed two Staff have sought support with how to have difficult childcare workers, nurses, psychologists and other rewrites of the units Infant Feeding and Nutrition and conversations and manage any underperformance child and family health professionals. Our leadership Perinatal Mental Health to ensure students share the issues. This will be a focus of activity and leadership in education also includes the delivery of Parent- most contemporary, evidenced-based information. development in our action planning. Child Interaction Therapy (PCIT) training and family partnership training. The 2020 Child and Family Health Prize recipient Karitane Professional Development is Jen Patterson. & Training This year, we held 21 workshops for 489 professional participants who work with families and children, Opportunities for professional development are including the NSW Department of Communities key for our innovative practice and this year we and Justice, Anglicare, Red Cross, the NSW Nurses provided 37 internal education sessions, with 348 Association (of over 100 participants) and child and participants. In addition to this, we continued to family health teams across NSW local health districts. offer a comprehensive framework of support for
48 | Annual Report 2020 Karitane | 49 Staff Health & Wellbeing Recognition of Achievements Organisational Structure With the COVID-19 pandemic, the wellbeing of We would like to congratulate: staff was a priority. We followed all guidelines from Sue Morgan, Clinical Nurse Consultant the NSW Public Health Unit and took all possible Sue was awarded the prestigious PCIT International precautions to prevent the spread of COVID-19. Research and Innovation Award, has been invited Board Directors This included screening all families and staff to apply for Global Trainer status, and been chosen attending our services each day, adhering to physical as Chairperson of the PCIT International Development distancing guidelines, and introducing a range of Taskforce. Chief Executive Officer enhanced infection control measures — including (Company Secretary) Martha Vasquez, Nurse Unit Manager increased cleaning schedules at all sites. We trained Martha successfully completed her Master of our clinicians to provide services virtually and Advanced Nursing Management. provided our team with the tools and flexibility to work from home. Zora Marjanac and Natasha McCloud, Nurses Executive Assistant Director Clinical Chief Financial Officer Director Education Director Governance Zora and Natasha successfully completed their The Karitane Wellbeing Committee, which promotes To Chief Executive Services & Business & Corporate Services Graduate Certificate in Child and Family Health Officer & DCS Development (Company Secretary) access, engagement and improved health and Nursing. wellbeing outcomes, provided fortnightly wellbeing Paediatric & General Executive Secretary updates to ensure everyone had access to self- Belinda Lloyd, Clinical Coordinator, Bhumi Research Academic Practitioners/VMOs/ To DGCS, CFO, directed activities and resources that could contribute Shah, Finance Assistant, Melanie Hughes, Coordinator Staff Specialists DEBD to their wellbeing. Our allied health educator Safety and Quality Coordinator and Tania Residential Unit & Health Information Payroll Coordinator Nurse Educators developed eight mindfulness videos and the team Trapolini, Allied Health Coordinator Parenting Centre Manager Nursing Unit was encouraged to take short wellbeing breaks Belinda, Bhumi, Melanie and Tania successfully Employee Services Managers Accounts Payable/ Clinical Nurse throughout the day. Coordinator Clinical Coder completed the People Management Skills program. Receivable Educators Digital & Telehealth Coordinator Manager Maree Pascale, Administration Officer Allied Health Work Health Safety Marketing & Educators Coordinator Fire/ Maree successfully achieved a Statement of Business Analyst Communications Karitane Linking Security/Fleet Attainment in Medical Records Coding. Families Manager Manager Perinatal Infant & Child Mental Hotel Services Finance Assistant Health CNC Coordinator Marketing & Events Volunteers Coordinator Community Safety & Quality Child & Family Programs Project Coordinator Health Clinical Nurse Officers Consultant Information Education Technology Project Integrated Care Administration Officer Officer Hub Manager Maintenance Aboriginal Health Coordinator Education & Liaison Officer Consumer Representatives Administration Officers
Perinatal Infant & Child Mental Health Manager
KEY Perinatal Infant & Psychiatry VMOs/ Allied Health CEO Chief Executive Officer Child Mental Health Staff Specialists Coordinator CFO Chief Financial Officer Coordinator CNC Clinical Nurse Consultant DCS Director Clinical Services DEBD Director Education & Business Development DGCS Director Governance & Corporate Services VMO Visiting Medical Officer
50 | Annual Report 2020 Karitane | 51 Board of Directors Executive Team Volunteers
Thank you to our team of passionate and dedicated volunteers.
Amy Cady Nicky Driver Anna Duncan Pauline McCloughan Anh Linh Pham Raghba Latifi Audrey Leishman Rikki Brownlow Barbara Anderson Robyn Howarth Lee Carpenter Dr Sharyn Wilkins Bernadette Keenan Charmion Ingram Grainne O’Loughlin Angela Wood Be Nam Huynh Robyn Jacob Chairman Director, Vice Chair, Director, Chair: Director CEO and Company Director: Clinical Services CPA, MBA, GAICD Chair: Clinical Nominations Committee BFA, MBC, DFP, GAICD Secretary Dip of Applied Science Birgitte Rogers Rosemary Van Bergen Governance Committee RN, Orthopaedic Nursing BSc (Hons) Sp. Th., MBA, Nursing, Grad Dip Child Catherine Corbett Roxene Quinn MBBS 1985, Family Certificate, Sterilising GAICD and Family Health, Grad Carol Jeffree Ruth Altman Medicine Program, Family Technology Certificate, Dip Critical Care Nursing, Planning Certificate, BHA (UNSW), GAICD Dip Management David Georges Ruth Craven GAICD David Seacombe Ruth Waters Debbie Corlet Sarah Bryce Deborah Saad Sharmeen Alam Denise Ghali Sue Rankin Eleanor Delaney Susan Mumford Gayle Murphy Swindle Steven Georgina McCudden Sylvia Capra Gladys Aguilar Tamara Elsum Helen Arabzade Talisha Anaki Elyse Jeffress Garth Ross Lesley Jordan Marion Skulley Dushi Goonesekera Karen Edwards Imogen O’Grady Tina Li Director, Chair: Audit, Director, Treasurer, Director Director, Chair: Business Chief Financial Officer Director: Governance and Irene Gowans Valerie Kennedy Risk and Governance Chair: Finance Committee Dip App Sc (Nursing), and Innovations BA Business Corporate Services and Committee BBus CPIM CM, Grad Cert Women’s Committee Administration, Member Company Secretary Jean Michaels Victoria Sammour LLB (Hons), GradCertHPol Health, MHM (with MBA IMD Lausanne, of CPA Australia and UK BA Honours, Grad Cert Joan Garriock Distinction), GAICD AICD, Dip Psych (ACMA), Chartered Global Adult Ed, M.Clin Psych Karen Carpeter Management Accountant (CGMA) Karin Kraugh Kay Walsh Keith McNaughton Kelly Parker Leanne Blaker Leanne Lambros Linda Traub Lorraine Burrows Margaret Haywood
Nicholas Nogarotto Sarah Barter Susan Dinkha Prof. Valsamma Eapen Sharlene Vlahos Margaret Hohaia Director Director Director, Chair: Audit, Director Director: Education and Maria Gianetti BA Economics (BEC) BA Psych, LLB, MPH Risk and Corporate MBBS, DPM, MRCPsych, Business Development Governance Committee Diploma in Family Therapy, BA Nursing, Cert Child and Maura Larkin BA, Dip Law (SAB) PhD, FRCPsych, FRANZCP Family Health, Masters Megan Hanna of Nursing – Clinical Leadership Management
52 | Annual Report 2020 Karitane | 53 Financial Overview
Treasurer’s Report Karitane achieved an operating surplus of $79,784 for The Finance Committee is appreciative of the Financial Year 2019-2020 compared to a surplus of professional and dedicated support of the CEO, $66,307 in the prior year. CFO, Company Secretary and finance team.
Total revenue for the year was $11.9million (2019: The Board of Karitane is committed to our strategy $10.6million). Our revenue for the year grew by 12% of innovation & growth to support the changing needs with an increase in government funding to $9.2million of families and communities whilst focussing on by 18% (2019: $7.8million). The total expenditure financial stability and sustainability. for the year was $11.8 million (2019: $10.5million) representing an increase of 12% from prior year.
The Year 2019-2020 was a year like no other with impacts of natural disasters and COVID-19. Karitane Garth Ross was able to react swiftly and effectively during this challenging year and respond to an increase in demand for our services. Government funding of $1million in JobKeeper during the year supported us to transform our services to virtual and telehealth models of care with the assistance of our agile, resilient and talented workforce.
Our donation revenue increased by 32% to $1.3million from previous year enabling us to support families through our parenting support services, upgrade our residential unit facility at Carramar, progress with our commitment to deliver collaborative integrated care services with our partners and provide the Volunteer Family Connect Program.
Karitane‘s net assets at 30th June 2020 were $14.9million (2019: $14.7million). Our cash position remains strong at $2.3million compared to $992K in the previous year to support our current service provision and provide a strong platform for growth.
On behalf of Karitane and the Board I thank our funders including the NSW Government, Federal Government, NSW Ministry of Health, South West Sydney Local Health District, corporate and NGO partners, major donors, our regular and new givers, trusts and foundations, clubs, local councils and sponsors for their continued generosity and support.
54 | Annual Report 2020 Karitane | 55 Statement of Profit or Loss and Other Comprehensive Statement of Financial Position Income for the year ended 30 June 2020 For the year ended 30 June 2020
2020 2019 2020 2019 $ $ $ $ Revenue from continuing operations 10,197,194 9,906,054 Current assets Other revenue and income 1,706,197 755,367 Cash and cash equivalents 2,309,744 992,719 Total revenue and other income 11,903,391 10,661,421 Trade and other receivables 634,756 345,859 Financial assets 4,010,335 4,562,675 Expenses Other assets 148,372 97,718 Employee benefits expenses (9,095,980) (7,446,719) Total current assets 7,103,207 5,998,971 Depreciation and amortisation (601,237) (487,303) Occupancy expenses (352,747) (580,113) Non-current assets Fees written off (53,259) (111,025) Property, plant and equipment 12,904,385 13,062,887 Provision for doubtful debts (7,586) (3,664) Right of use asset 126,793 - Printing and stationery expenses (93,174) (102,160) Financial assets 489,031 499,550 Telephone expenses (52,576) (41,601) Total non-current assets 13,520,209 13,562,437 Repairs and maintenance expenses (211,452) (421,236) VMO expenses (226,032) (381,296) Total assets 20,623,416 19,561,408 Consultancy expenses (467,023) (280,960) Other expenses (662,541) (739,037) Current liabilities Total expenses (11,823,607) (10,595,114) Trade and other payables 1,222,595 1,246,179 Employee entitlements 2,619,448 2,312,758 Net surplus for the year before income 79,784 66,307 Lease liability 142,664 - tax expense Deferred revenue 1,565,869 1,178,123 Income tax expense - - Total current liabilities 5,550,576 4,737,060 Net surplus for the year 79,784 66,307 Non-current liabilities Other comprehensive income Employee entitlements 115,955 95,937 Revaluation of land and buildings 148,690 35,942 Total non-current liabilities 115,955 95,937
Total comprehensive income for the year 228,474 102,249 Total liabilities 5,666,531 4,832,997
Net assets 14,956,885 14,728,411
Funds Accumulated funds 9,191,136 9,111,352 Reserves 5,765,749 5,617,059 Total funds 14,956,885 14,728,411
56 | Annual Report 2020 Karitane | 57 Donors & Community Funding Providers (continued)
Thank you to our Funding Providers, Community Partners and Supporters
11% Donations & Sponsorships Community Partners Govt Subsidies 81% & Grants 3% Other Income (including investment interest) 5% Patient Fees
Funding Providers South Western Sydney Local Health District Private Donor NSW Department of Communities and Justice Department of Social Services NSW Ministry of Health Mission Australia The Benevolent Society Mr Anthony and Mr Ronald Perich Youth Justice NSW Cabra-Vale Diggers Club The Fred P. Archer Charitable Trust Petersham RSL Club Rotary Club of Narellan Mounties Group Liverpool Catholic Club Supporters South Sydney Junior Ruby Leaugue Club Campbelltown Catholic Club Camden Council Health Education and Training Institute Healthy Kids Foundation by Wests League Club Kids of Macarthur Health Foundation Maroubra Seals Sports and Community Club Camden RSL Club Coogee Diggers
58 | Annual Report 2020 Karitane | 59 60 | Annual Report 2020