Waiting to get help at RISE

Over the last few years, it’s taken longer than we would like for some newly referred clients to start their programmes at RISE. We know you’ve noticed as it’s probably one of the most frequently asked questions we get: what is the deal with the wait list?

Adults

Unfortunately, the wait list has become a more regular part of our process. It started with COVID-19 in 2020 and has developed into a more regular situation since that time, though wait times have diminished and grown here and there. Still, we are concerned that it could become more regular and thought it a good time to update you on the situation.

When RISE is well-staffed, we have historically been able to operate without a wait list. The simple process is that we receive a referral form from a referring agency or person and our team books an assessment appointment between the new client and a clinician. This usually takes about a week on average.

Sometimes a short delay can arise because we look to pair the client with the most appropriate clinician based on the client’s situation and the incident they were involved with. If that clinician doesn’t have an opening for a week or two, that could cause a delay. We feel the delay is manageable because we prefer to establish a strong relationship between the client and clinician. Having said that, emergencies do occur and we respond to those right away. In either situation, we are always in communication with the new client and the referrer about the timing of the initial assessment.

The assessment can take multiple meetings, each one week apart. All things going well, the new client will move next to an orientation meeting that happens before they join the Non-Violence Programme. Quite often there are delays at this point in the process because new clients can only begin the Programme at the start of a module. The Non-Violence Programme has four modules that each run for four weeks. If a new client has completed the assessment and the orientation, and the new module is scheduled to start shortly, then the process is more seamless. If the new module is several weeks away, however, that will mean a delay for the new client’s start date. Unfortunately, this has to happen because everyone needs to participate in each four-week module from start to finish.

The ideal scenario described above happens most of the time when we are fully staffed, when everyone is reasonably healthy, and when there’s not a worldwide pandemic(!). But recent challenges have not only included everything related to COVID-19 lockdowns, staff illness, new client illness, childcare challenges, and catch-up on family visits and holidays.

While we plan for and normally work around staff absences, COVID has affected our team like many. And we have had a few vacancies in the last year and this has affected our ability to manage a full case-load. To deal with these inevitable gaps, we made administrative changes early in 2022 to help alleviate waiting times and gaps where we could, including holding times each week with each clinician for assessment appointments on a first-come first-booked basis.

The more significant cause for the wait list is the increase in new client referrals since 2020. At times we have more new clients than we have full staff capacity. Thankfully, increased, short-term funding has helped ease this in the last 2-3 years but the funding hasn’t been made permanent while the need has continued to grow.

At the worst times following COVID lockdowns, we were seeing new clients wait 6-8 weeks for the assessment appointment and this was the longest wait we had ever experienced. Much of the delay was due to the causes mentioned above, but also challenges faced by the new clients in very difficult times. People were out of work, there were childcare issues, and it was more common to have appointment cancellations because of everything going on in people’s lives. These circumstances reduced in 2021 but are now happening again with more frequency since New Zealand isn’t mandating a COVID protocol. Whether it is our staff or a new client, appointments have had to be rescheduled much more frequently during this time than in the past, which makes for a lot more juggling with the schedule and the inability to fill those appointments on a last-minute basis to accommodate everyone.

We hope this explanation of how the system works will give you more reassurance about the wait list. The wait list has grown and it has eased back to normal – and then moved up and down again over recent months. Our administrative processes are continually reviewed to address these challenges and look for solutions.

If a situation arises when a new client becomes unsafe around themselves or others, referring agencies are invited to contact us and we can discuss the situation further.

Children

As the only specialist family violence organisation in the Te Tau Ihu, there is strong demand for services for children who have experienced family violence. Working with children is a particularly specialised field and not all RISE clinicians practice this specialty. Combine that with a recent increase in referrals for these services, and most new child/youth clients who come to RISE are added to a wait list for their first appointment.

Most of our clinicians see children for longer than they do adults. The work can sometimes be more complex than work with adults, but more often the length of time is due to the need to work at the child’s pace and this can’t be predicted or managed. For example, one clinician has been seeing a child for nearly 3 years. As a result, it means there are fewer appointment times available for new clients.

Another factor working to grow the wait list is basic availability for everyone to participate in the required meetings. When a child comes to RISE, it usually means it’s a challenging time for the child, parents, other caregivers, and the entire family. Every new client – child or adult – has to participate in an initial assessment appointment. For children, it must include a parent. Sometimes it can be challenging to get the child and a parent together for this meeting.

Also, as the child’s availability for each appointment is dependent on the parent, there are often missed or rescheduled appointments with child clients. When this happens, one’s instinct might be to fill that slot with a new client, but this is problematic because the clinician only has this one opening and next week at the same time, the existing client is booked to have their weekly session. When a new client starts, they are booked for a group of weekly sessions over a period of time. When one cancellation happens, it doesn’t mean a new client can just slot in for that week; they need to be able to be scheduled for the long-term.

As a referrer, if there is anything you think you can help with regarding scheduling challenges, we welcome your assistance. We know the whanau is in the middle of a difficult time and has many priorities to juggle, so we are accommodating. Unfortunately, it also has repercussions for new clients who need to be seen and results in the wait list.