The Role of the Accident Compensation Corporation in the Prevention of Family Violence in Aotearoa New Zealand and promising practices to reduce the incidence and severity of injuries from Family Violence-related assaults.

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Thames Valley University

Faculty of Health and Human Sciences

Double Dissertation Module

Level 3

The Role of the Accident Compensation Corporation in the Prevention of Family Violence in Aotearoa New Zealand and promising practices to reduce the incidence and severity of injuries from Family Violence-related assaults.

        


Contents

The Accident Compensation Corporation        

Family Violence in Aotearoa New Zealand        

The Cost of Family Violence to the Accident Compensation Corporation        

Health Promotion        

Injury Prevention        

Family Violence Prevention        

Primary Prevention        

Secondary Prevention        

Tertiary Prevention        

Prevention of Family Violence        

Parenting Programmes        

Universal Home Visits        

Social Marketing        

Universal Screening        

Education of Children and Young People        

Community Development and Action        

Working with Witnesses of Family Violence        

Working with adult female victims        

Working with Perpetrators        

Government Legislation and Strategy        

Health promotion: An approach to the prevention of family violence.        

The Role of ACC in family violence prevention        

Conclusion        

References        


Abstract

Family violence has been found to affect families from all cultures, backgrounds and socio-economic situations.  It can occur in all close personal relationships, wherever individuals are part of a family or fulfilling the role of family.  

The Accident Compensation Corporation of Aotearoa New Zealand funds the care and rehabilitation costs of all New Zealanders injured within the confines of Aotearoa New Zealand.  The huge cost of family violence to the Corporation requires ACC to act to reduce the impact of family violence on its claim costs.

Through supporting agencies working to reduce family violence at primary, secondary and tertiary levels, ACC will impact its own costs and thus the levies to its funders while contributing to making Aotearoa New Zealand a safe place for all, in line with the New Zealand Injury Prevention Strategy.

Approaches to reducing family violence include parenting programmes, universal home visits, social marketing, universal screening, education of children and young people, community development and action, working with victims, perpetrators and witnesses of family violence and implementing Government legislation and strategies.

Health promotion theory provides an ideal framework to ensure that family violence is being addressed at every level.  Through identifying effective interventions and placing them with a health promotion framework, recommendations for the Accident Compensation Corporation’s role can be made.

Acknowledgements

My thanks go to my colleagues at the Accident Compensation Corporation and the members of the Te Rito Advisory Group for their support and advice in preparing and writing this paper.

Introduction

This paper will examine the role of the Accident Compensation Corporation in reducing the incidence and severity of family violence in Aotearoa New Zealand.  It will also provide an overview of family violence and effective health promotion and injury prevention models to reduce the effect of family violence on society (Ministry of Social Development 2002, Department of Child, Youth and Family Services 2001, Ministry of Health 2001).

I will begin by introducing the New Zealand accident compensation scheme and providing an overview of family violence and its cost to the Corporation.  I will then look at the most common approaches to health promotion and injury prevention in Aotearoa New Zealand before moving on to explore examples of initiatives that have taken place both locally and internationally to prevent family violence, showing how these fit within a health promotion framework and finally, providing recommendations for the Corporation’s future involvement in this field.

The Accident Compensation Corporation

The Accident Compensation Corporation / Te Kaporeihana Äwhina Hunga Whara (ACC) was established on 1st April 1974 to administer a no-fault coverage against injury scheme for every New Zealander (ACC 2004).  The accident compensation scheme administered by the Corporation came into being as a result of a 1967 Royal Commission looking into workers’ compensation; in 1972 Parliament adopted the recommendations of the Royal Commission and passed the Accident Compensation Bill into law.  The original system had three parts:

  • Compensation for work injuries, funded through levies paid by workers and their employers;
  • Compensation for road injuries, funded through levies paid by owners of motor vehicles;
  • Compensation for everyone else, funded through the New Zealand Government.

There have been many changes in the scope and structure of the Accident Compensation Corporation since its inception, primarily as a result of changing legislation.   The scheme is now primarily governed by the Injury Prevention, Rehabilitation and Compensation Act 2001 (IPRC).  The IPRC is essentially a set of regulations governing who is entitled to compensation, what is covered by the scheme, how the scheme is funded and how much can be paid out to claimants.

A major change brought about by the introduction of the IPRC has been an increased focus on injury prevention.  Section three of the Act provides the Corporation with the responsibility “to enhance the public good and reinforce the social contract represented by the first accident compensation scheme by … minimising both the overall incidence of injury in the community, and the impact of injury on the community (including economic, social, and personal costs)” (IPRC 2001).  Section 263 of the IPRC requires that the Corporation undertake injury prevention work if this is likely to result in a cost-effective reduction in either levies or the government contribution to the scheme.  The Corporation is also required to co-ordinate activities with other government agencies to increase the efficiency and effectiveness of its injury prevention activities.

In addition to its interest in assault as a result of the IPRC, the Corporation is a key stakeholder in a number of strategies which impact on family violence.  These include:

  • Te Rito: New Zealand Family Violence Prevention Strategy (Ministry of Social Development 2002);
  • Crime Reduction Strategy: Action Plan to Reduce Community Violence and Sexual Violence (Ministry of Justice 2002A). 
  • New Zealand Injury Prevention Strategy (Minister for ACC 2003);
  • Opportunity for All New Zealanders (Office of the Minister for Social Development 2004).

Whilst not a major stakeholder in the area of assault within these strategies, the Corporation as a result of its interest in the prevention of intentional injury has the potential to play a major part in operationalising these strategies.

Family Violence in Aotearoa New Zealand

Family violence is a significant issue in Aotearoa New Zealand; it creates major social and economic costs for our society.  Family violence has been found to affect families from all cultures, backgrounds and socio-economic situations.  It compromises the safety of children, adults and elders and its effects are broad and multi-dimensional.  The need to understand and address family violence is not new, however identifying effective best practice can be problematic.  A broad range of controlling behaviours falls under the banner of family violence.  These typically lead to fear, intimidation and emotional deprivation through psychological, sexual and emotionally abusive behaviours.  Family violence can occur in all close personal relationships, wherever individuals are part of a family or fulfilling the role of family.  Common forms of violence within the family include:

  • Spouse or intimate partner abuse (violence and abuse between adult partners);
  • Child abuse or neglect (abuse and neglect of children by an adult);
  • Elder abuse or neglect (abuse and neglect of people over the age of 65 by a person or persons with whom they have a relationship of trust);
  • Parental abuse (violence perpetrated by a child against a parent);
  • Sibling abuse (violence perpetrated between siblings).

(Ministry of Social Development 2002, Ministry of Health 2001)

Family violence is a major social problem, estimated to cost Aotearoa New Zealand between $1.187 billion and $5.302 billion per year (Snively 1994).  It further contributes to the continuation of the cycle of abuse within families and in society in general (Ministry of Social Development 2002).  The perpetrators of the most severe and lethal cases of family violence are predominantly men; their victims are predominantly women and children.  Tangata whenua are significantly over represented as both victims and perpetrators of family violence.

The best available population-based estimates of partner abuse suggest that 15 - 35 percent of women are hit or forced to have sex by their partners at least once in their lifetime, while seven percent of men report experiencing this type of abuse.  A 1995 study revealed that one in five New Zealand men admitted assaulting their partners in the previous year (Leibrich, Paulin & Ransom 1995).

Men assaulting their women partners comprise between 86 percent (New Zealand Police Statistics for 1996/97 operational year, men were the offenders in 86.7 percent of Family violence incidents) and 98 percent (Hamilton Abuse Intervention Project database, 1991-1994).of family violence-related arrests. New Zealand studies found that 35 percent of men reported physically assaulting their partners (Leibrich, Paulin & Ransom 1995) and 33 percent of women reported physical or sexual abuse from their male partner (Morris 1996).

According to the Ministry of Health (2001), lifetime estimates of child abuse suggest that between four and ten percent of New Zealand children experience physical abuse and approximately 18 percent experience sexual abuse.  Between 1996 and 1997, 38,000 children were present during the 30,340 family violence incidents attended by New Zealand Police; 28,621 were under 10 years old, and 9,844 were aged between 10 and 16 years (New Zealand Police 1997).  From interviews with children, researchers found that almost all can describe detailed accounts of violent behaviour that their mother or father never realised they had witnessed (Jaffe, Wolf & Wilson 1990).

In the year to June 2000, the Department of Child, Youth & Family Services assessed 6,833 children as abused or neglected (Ministry of Social Policy (now Ministry of Social Development) 2001).  Further, in the four years to 2002, over 1,600 children under the age of 10 years were sexually abused.  Given the nature of this issue, the number of child victims (as with women) is considered grossly underrepresented.

Research indicates that there is considerable overlap between physical, psychological and sexual abuse, and children who are subject to one form of abuse are significantly more likely to suffer other forms of abuse (Briere & Runtz 1990).

There are significant overlaps between male violence against female partners and child abuse and neglect.  A comprehensive review of studies in this area indicates that in 30 to 60 percent of families where either child abuse or partner abuse is found, the other type of abuse occurs also (Edelson 1999).  The likelihood of co-occurrence of child abuse increases with increasing frequency of partner abuse.

Most research estimates that between two and five percent of the older population are victims of elder abuse.  In Aotearoa New Zealand, based on the 1996 census, this means there could be between 8,453 and 21,133 older New Zealanders suffering from some form of abuse and neglect.  Most elder abuse victims are aged 70 to 84 years, with psychological abuse considered the most common type of elder abuse (Age Concern New Zealand 1992).

For the purposes of this paper, family violence will be assumed to include intimate partner abuse and child abuse or neglect.  The prevention of parental, elder and sibling abuse are beyond the scope of this discussion, primarily due to the lack of clear evidence that these present significant cost to the Accident Compensation Corporation.  It should also be noted that these three areas are not currently being prioritised within either Opportunity for All New Zealanders or Te Rito: New Zealand Family Violence Prevention Strategy.

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The Cost of Family Violence to the Accident Compensation Corporation

The costs to ACC of providing treatment and entitlements in respect of assault (excluding sexual abuse) cannot be easily identified, particularly as many claims are processed through the bulk funded emergency departments of public hospitals.  Recent estimates of the cost of assault to the Corporation suggested a possible 6,660 cases at a cost of over NZ$21 million (Stephenson, Trotter & Langley 2004).  According to Statistics New Zealand (2001), “male assaults female” (i.e., intimate partner abuse) is the most common type of violent crime recorded by New Zealand Police and thus ...

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