Working with young people who have complex needs

Young people who are transitioning to adulthood have the same needs as those who are not in care, but they also face a range of unique issues and circumstances that highlight their need for particular support during this time, as described in the graphic below.

Where ongoing support and suitability for the program is identified, local processes for formally requesting support from Specialist Services should be followed. This may include completing a Request for support form. Any request will include written confirmation that both the regional line manager and the senior program officer are aware of the need for support.

Contemporary research indicates that young people leaving care have a significantly greater risk of becoming involved in:

• social isolation
• unemployment
• poverty
• homelessness
• mental health concerns
• misuse of drugs or alcohol
• sexual exploitation.

Additional consideration must also be given to young people transitioning to adulthood who may experience barriers to participating fully in opportunities, including those who:

• are Aboriginal and Torres Strait Islander
• have diverse sexual orientation, gender identity and gender expression
• have disabilities
• have been a victim of crime
• live in rural or remote areas
• are from a culturally and linguistically diverse backgrounds
• are pregnant or are young parents
• are homeless or highly mobile or have had multiple/unstable care arrangements
• have contact with the youth justice system
• have mental health conditions
• engage in problematic substance misuse

• engage in non-suicidal self-injury.

Refer to the Transition and post care support program.

Working with a young person with a disability

The following approaches can be helpful to ensure young people with a disability experience a planned transition to adulthood:

• Ensure the young person has a genuine opportunity to participate in the planning process by using a person-centred planning approach to discover how they want to live their life, and what is required to make that possible.
• Adapt the plan so that it is accessible and meaningful to the young person. This may include the use of photos or a visual representation of the plan.

Use the young person’s existing National Disability Insurance Scheme (NDIS) participant plan and professionals identified in the plan to inform the planning process. For example, a speech and language therapist who works with the child can assist in eliciting their views.

Young people who are already receiving supports through the NDIS may benefit from a more comprehensive assessment in partnership with their guardian or representative and NDIS support coordinator, to assist with NDIS plan reviews when they are 17. This will ensure the young person has an NDIS plan that will meet their needs, particularly in terms of funding for the supports needed in independent living.

Young people with complex disabilities (especially those placed in the care of another entity through the Individualised placement and support business rules) require very high levels of daily living support, may need significant planning for funded adult care arrangements. Planning for this will need to start well ahead of the young person reaching adulthood to ensure assessment of needs, approvals of funding, and transition to new care arrangements.

NDIS accommodation and support arrangements for young people transitioning to adulthood may include:

• supported independent living and independent living options
• specialist disability accommodation options

• school leaver employment supports for young people who need extra help to achieve their employment goals.

Transition and post care support program

Contact can be made with a Transition Officer in your region to discuss whether a young person may be suitable to access support through the transition and post care support program.

The transition officer can start supporting a young person in care from 15 years of age, with support increasing in intensity at the ages of 16–17 years and through transition. Post care services are available for young people up to 21 years of age.

Transition officers provide direct support to young people in care to ensure they experience a safe and stable care arrangement that supports community living, involvement in work, training or appropriate daytime activities, and helps build and maintain relationships.

Where ongoing support and suitability for the program is identified, local processes for formal requesting support from Specialist Practice should be followed. This may include completing a Request for support form (available from your regional transition officer.)

When a young person has impaired decision-making capacity

The Queensland Civil and Administrative Tribunal (QCAT) can make decisions about decision making for adults with impaired capacity, including financial decisions (administration) and personal and health decisions (guardianship).

When a young person with impaired decision-making capacity requires their interests to be protected and their needs to be met after they turn 18 years of age, we need to make an application to QCAT as soon as possible after the young person turns seventeen and a half years. This allows adequate time for the investigation and hearing by the tribunal. The transition officer will know a lot about substitute decision making and the role of QCAT and the Office of the Public Guardian and will be able to provide advice and support to the CSO.

According to QCAT, there are three elements to an adult making a decision:

• understanding the nature and effect of the decision
• freely and voluntarily making a decision
• communicating the decision in some way.

If an adult needs to make a decision and is unable to carry out any part of this process, they have impaired decision-making capacity.

QCAT can decide a range of matters about adults including:

• making a declaration about an adult’s decision-making capacity for some or all matters
• determining if informal arrangements in place are adequate to protect the adult
• appointing a guardian to make some or all personal and health care decisions 
• making a temporary decision to deal with an urgent situation
•  making a declaration about the execution and appointment of an enduring power of attorney.

See  Decision-making for adults with impaired capacity for more information about the role of QCAT and how to make an application.

The Office of the Public Guardian (OPG) is clear that if someone has impaired decision-making capacity it does not mean they can’t make any decisions. The law states people with impaired decision-making capacity have a right to adequate and appropriate support in decision making. The OPG uses a structured decision-making framework to ensure a young person with impaired decision-making capacity can meaningfully contribute to decisions made about them.

See Understanding guardianship making for further information and the full guardianship framework.

Working with a young person with diverse sexual orientation, gender identity, and gender expression

Using correct terms and language for gender diverse young people is empowering, demonstrates acceptance and can contribute to safety. Refer to the policy Children and young people with gender and sexual orientation diversity.

The acronym SOGIE-SC is a helpful way to remember and distinguish between important concepts when engaging with young people with diverse gender identity, gender expression and sexual orientation. SOGIE-SC means:

• SO – Sexual Orientation
• GI – Gender Identity
• E – (Gender) Expression
• SC – Sex Characteristics.

For detailed information such as definitions, language and terminology and helpful resources for practitioners read the Practice guide Supporting children and young people with diverse SOGIE-SC.

Working with a young person with mental health difficulties

The transition period may act as a trigger for mental health difficulties, self-harm or suicide.

We can improve outcomes for young people with mental health problems and/or problematic drug and alcohol use when they are transitioning to adulthood by:

• ensuring there is collaboration between agencies working on mental health services and child safety
• following an outreach model of support service provision with a shared focus on the complete needs of a young person.

Ensuring young people are linked to mental health services that can transition into young adulthood (such as Headspace) provides a safety net for future years.

Research has demonstrated that the factor most closely associated with good mental health outcomes among care leavers is having safe, stable and affordable housing.

Working with a young person who has youth justice involvement

Adolescence is the peak risk time for offending behaviour from a lifetime perspective due to the developmental characteristics of this stage of life. (Refer to Neural development.)

According to a report conducted by the Australian Institute of Health and Welfare, young people in care were 19 times more likely to also be under the supervision of youth justice compared to the general population of youth. Indigenous Australians are 16 times more likely than the non-Indigenous population to be both in the child protection system and under youth justice supervision.

These statistics do not imply that most young people who have had a history of abuse and neglect engage in criminal activity, but rather that a large proportion of young people who have offended have a history of abuse and neglect (Darker et al., CREATE (c)).

Ensure the transition to adulthood planning is coordinated and aligned with youth justice case plans. If appropriate, involve youth justice staff as part of the child’s safety and support network. Refer to Who is in the network.

Working with a young person who engages in high risk behaviours

Network members engaged in a high intensity response often undertake joint action to achieve a particular goal with the young person or family. A willingness to share resources, including financial, practical and timely, is important. The approach of working together—closely collaborating with a sense of immediacy or sharing tasks—adds value to the support being provided to the young person or family on several levels, including:

• it reinforces the sense of wrapping around of the young person or family in a supportive environment, and reinforces the core value of relationship
• it makes it more likely that safety and support network members will be able to support each other in relation to the crisis nature of the work, the high risk behaviours of the young person and the complex and at times difficult decision making
• it enables greater sharing of skills, information and resources
• it can help ease the pressure for young people of interacting with only one worker and allow choice in relation to different network members
• it can provide a consistent response, creating a sense of containment for a young person or family.

When the young person is transitioning to adulthood, careful thought is required to develop a safety and support network that will be sustainable into adulthood. This is an important time to revisit relationships with parents, siblings and extended family members, who while they may not have been able to meet a child’s needs when younger may have support to offer as they get older.

Where a young person has required a high intensity response as they approach adulthood, the network ideally will develop the ability to respond as needed without reliance on Child Safety to initiate and co-ordinate. Providers of professional and other services that are part of the network will gradually include those able to provide services beyond 18 years, such as Extended Post Care Support and Next Step Plus.

Young people who have been victims of crime

Most young people in care have experienced, been exposed to or been impacted by violence. Where an act of violence (a crime against a person) has occurred in Queensland, assistance may be available through Victim Assist Queensland, a unit of the Department of Justice and Attorney-General.

Victim Assist Queensland provides information on support services and may also be able to pay for services to help a person recover. For a young person transitioning to adulthood from a child protection guardianship order to the chief executive, Child Safety has a legislative obligation to assist with access to Victim Assist Queensland services and apply for possible financial recompense on their behalf.

At the time of beginning transition to adulthood planning with the young person, consider the harm which led them to come into care, or other events they have been involved in or impacted by since that time. Review file records and, if there is information identifying an act of violence or crime, check whether information about Victim Assist Queensland has been provided, and whether the incident was reported to the QPS.

Provide the young person with information about the help and support available from Victim Assist Queensland. Engage them in discussion about their right to apply for assistance, particularly as, if found eligible for support services and financial payment, this support is provided to them after they reach 18. Refer to Victim Assist Queensland for information about your obligations to support the young person.

The young person’s transition to adulthood plan will include information about any application to Victim Assist Queensland or plans for a potential future application for assistance. Discuss options sensitively at each review phase, recognising that talking about what they experienced may trigger a trauma response, and respect their decision.