Introduction by Croakey: Aboriginal community controlled organisations are leaders when it comes to principles of place-based approaches to improving health and wellbeing and addressing complex challenges.
Aboriginal Community Controlled Organisations (ACCOs) and Aboriginal Community Controlled Health Services (ACCHSs) emerged from the failure of mainstream services to address their communities’ needs.
They have also been leaders in taking holistic and responsive approaches, with community engagement and control central to all they do.
“ACCHSs have always been at the heart of Aboriginal communities, grounded in local values and culture, and providing a place for engagement, activism, employment and safe haven, in addition to delivering high quality evidence-based health care,” reported a 2016 review by the Aboriginal Health and Medical Research Council of New South Wales.
In the article below, David Tennant, CEO of FamilyCare Inc, which is based in the regional Victorian centre of Shepparton on the lands of the Yorta Yorta peoples, writes that place-based approaches can transform communities.
But, he says, echoing the warnings of ACCHSs over decades, if they are done to a place or community, rather than with them, place-based approaches can not only fail but cause significant harm.
David Tennant writes:
The concept of place-based service delivery is not new but is attracting a renewed burst of enthusiasm in Australian community services.
The extra attention makes sense. Evidence confirming links between deep and persistent disadvantage and location has been consistent for a long time. It is where social determinants intersect with local outcomes.
As the Victorian Government’s guide to place-based practice notes, Aboriginal communities “have led the way in articulating and demonstrating the strength of community empowerment through self-determination”.
“Place-based approaches share these same principles to provide impact to a broader range of vulnerable and disadvantaged communities,” it says.
There have been some excellent examples of mainstream place-based work in Victoria over the years.
The neighbourhood renewal program in Victoria, which ran from 2001 until 2013, helped to develop connections and infrastructure in a range of communities across the state.
More recently, the Geelong Project has tackled youth homelessness and disengagement from school, while Go Goldfields was established to improve outcomes for children and families in the Victorian Central Goldfields region.
Doing things in or to a place is not enough on its own however. Selecting locations for extra attention based on a perception of deficit can do harm if the people who live in that location do not agree with the assessment or have no agency in the process.
I live and work in the regional Victorian city of Shepparton, for an independent not-for-profit agency that draws its licence to operate from the community. Like many regional communities, Shepparton has its challenges. It also has considerable strengths.
Our community has had a range of experiences in being selected for place-based activities, including some where we can only conclude that the state itself is the single biggest driver of structural disadvantage in income poverty in Australia.
There are parallels between the experience of ‘place-based welfare conditionality’ in Shepparton and beyond and the failed top-down punitive approach of the Northern Territory Intervention.
Those experiences have underlined how important genuine engagement is in place-based work. To follow are a few priorities that help me and my colleagues constantly review what we do, how we do it and how we connect with community.
1. Connection to community evolves, like any relationship
The ‘place’ context for community organisations is more than just physical. It includes links with people – board members, staff, volunteers, and service users. It also incorporates an appreciation of shared history, including aspirations and challenges.
Communities, even small ones, are rarely static or homogenous. They change and evolve and so should the community organisations that seek to understand and respond to local needs.
2. No one has more experience than the person living the experience
Discussions about place-based service responses often prioritise being client-centred and aspire to undertake ‘co-design’. Both require effective and appropriately sensitive processes to engage with potential service users, to understand what drives need and how people would like services delivered.
In rural, regional, or remote contexts, assumptions about lived experience made in other places without connection to service users where they live risk a range of poor outcomes, from irrelevance to causing or exacerbating harm.
We saw the harm first-hand in Shepparton after being selected as one of ten place-based welfare reform trial sites in May 2011.
As an example, that selection resulted in Shepparton becoming one of the first places in Australia to host an intensive form of ParentsNext.
Single parent households, most headed by a woman, faced acute pressure to engage in pre-employment activities or face suspension of benefit incomes, all while still being responsible for the full-time care of very young children.
There was no appreciation of extra challenges like a lack of public transport and an absence of part-time employment options suitable for people with primary school aged children.
3. Problems with policy or service design are not solved through more targeted or place specific delivery
In the past, approaches to evaluating programs that aim to address place-based disadvantage have been patchy, making it hard to get a reliable read on impact, good or bad. That said, if the indicators that prompted intervention get no better, or become worse, it should raise concerns and often has not.
Bad policy is unlikely to work well anywhere. In communities already struggling, it can amplify disadvantage. That has been my experience, for example, of punitive welfare conditionality measures, targeted at places where people experience elevated disadvantage. Some measures plunged participants into rolling crises. They also harmed relationships between service providers acting as delivery partners, service users and the broader community.
4. Respecting places and people
Commitments to develop place-based thinking and planning are exciting. A group of larger community organisations recently provided their views on how to progress this work in a publication called Strengthening Communities.
Many of the recommendations in that paper focus on how resources are delivered, the length of service contracts and the design of governance arrangements.
Those issues are important but so are practical, grass-roots needs. If people do not see themselves or their community in an initiative, it will struggle to be effective, no matter how well intentioned or funded.
Doing things in places is the easy bit. Connecting properly with the people in those places is harder but much more important.
*David Tennant is the CEO of regional Victoria not-for-profit service provider, FamilyCare. FamilyCare participates in several groups of independent, place-based community services, including Shepparton Community Share and a network involving Brophy Family and Youth Services, CAFS Ballarat, Family Life, Mallee Family Care, Kids First Australia, Upper Murray and FamilyCare.
Read Croakey’s archive of articles on social policy and health