The Challenge of Change

As the CEO of one of the largest Not for Profits dedicated to improving the lives of women, Dr Robyn Gregory has proved to be a tireless advocate for equality. Gregory is this week’s Changemaker. She spoke to Xavier Smerdon.

Dr Robyn Gregory runs Women’s Health West, a Not for Profit promoting women's health and responding to family violence for the entire West of Melbourne.

The geographical area the organisation covers is a challenge in itself, spanning more than 1300 square kilometres and including dozens of suburbs, many of which are home to people from vastly different cultures.

The issues the organisation is working to tackle, such as violence against women, sexual and reproductive health and mental health, are even more challenging.

In this week’s Changemaker, Gregory talks about the hurdles facing an organisation trying to implement systemic change and what inspired her to keep on fighting.

Can you tell us a bit about your background before you came to Women’s Health West?

I’ve done quite a lot of work in the area of women’s health and family violence for a good bit of my career. My background is in social work originally, I’ve got a PhD in women’s health policy and have worked variously at the Royal Women’s Hospital. I taught social work at LaTrobe University for a number of years and I’ve worked in local government out in Melton and various other places. I also worked at the Women’s Policy Coordination Unit back in the days under the Cain and then the Kerner Government.

So I’ve had quite a strong history of research, policy, direct service delivery and education. I also coordinated, back in the 80s, a family violence service, a women’s refuge. So quite a bit of my career in one way or another has been spent in the area of women’s health and safety.

How long have you been CEO at Women’s Health West?

Since 2008, so a bit over seven years.       

What is your organisation working on at the moment?

There are two main parts of the organisation, our two main service arms for want of a better term. One is a large family violence service which covers the Western Metropolitan Region of Melbourne. We offer an integrated suite of services from police referrals. They fax the details of women and children to our service and we offer a crisis response immediately after an incident of family violence.

We have case management services that work with women for up to three months and intensive case management that works for probably six months to 12 months with women who are at a higher risk of violence or have particular additional barriers such as disability or a really particularly high risk of violence complexity around mental health, drug and alcohol use.

We have refuge and housing accommodation options and court support, which is a really big growing part of the work where people are going to court for intervention orders. So we offer a suite of crisis and case management services and we also have healing and recovery services around women and children’s counselling and group work for children.

That’s one arm of our service and the other arm helps promotion, research and development. That arm works in relation to three priority areas. Given that working with women is huge, there’s obviously a million different things you could do as a women’s health service, so what we did was to sit down and say “what are the three areas that if we really made traction in these areas would have significant gains from women’s health, safety and wellbeing?” The three areas that we’ve chosen are sexual and reproductive health, mental health and wellbeing, and the prevention of violence against women. Probably, if we were speaking more broadly that last one could be expanded to the prevention of violence and discrimination against women, given that the western suburbs has a highly multicultural population, and we’ve really found muslim women have suffered from verbal and sometimes physical abuse given the rise of a bit of an anti-Islam focus from the Federal Government that’s been reflected in parts of the media and parts of the population.

But largely part of the uniqueness of Women’s Health West as a service is to be able to work from the primary prevention of violence against women through to early intervention and tertiary service responses.      

We’ve seen the issue of violence against women and children in the headlines a lot lately. How in demand are your services? Are you finding it quite straining?

We are. It’s extraordinarily demanding. I think the demand was already high. If I look at our police referrals alone, and obviously we get lots of referrals from methods other than via the police, but if you look at just our police referrals, two years ago they increased by 54 per cent in one year and in the same year we got a two per cent increase in funding. Then in the last 12 months they’ve increased on top of that 54 per cent by another 32 per cent. We have been fortunate in picking up some additional funding over the last 12 months, so that’s been great.

I think that the culmination of Rosie Batty, the extraordinary Rosie Batty being made Australian of the Year, plus the State Government’s Royal Commission into Family Violence, has meant that the demands we were already feeling strongly took another spike. We also noticed a little bit of a shift in that women that were calling us directly were often women who had experienced family violence in the past, and sometimes quite a long time ago, and the Royal Commission had raised quite a lot of topics for them that they really wanted to talk through and seek information and perhaps [receive] referral for counselling.  

In the last financial year we had about 8200 referrals, the year before was about 6200. So there’s been a really big jump in demand and what happens when you have a spike in demand is that if you don’t have the funding to match that demand, you’ve got to bring demand management strategies into play. We’ve  been in a position where we’ve had to move our case management resources up front into crisis management and court support in order to literally deal with that demand, as well as putting some limits around the nature of referrals that we’re able to accept.

It’s been really tough and we’re very much looking forward to the outcomes of the Royal Commission although mindful that it won’t be for some months yet.  

How do we break that cycle of domestic violence? Are we doing enough?        

I don’t think enough. Certainly with the Royal Commission into Family Violence, prevention as well as response and early intervention are on the agenda but I do think that prevention has remained somewhat invisible in the hearings of the Commission.

I’m sure there are a number of submissions they’re going through that do talk about prevention as well but in the actual formal hearings to date, there’s been very little concentration on prevention and that does really bother me. I know across Victoria the women’s health services in each of the regions are leading work to develop regional action plans… so there are a number of partners working together with a really terrific plan for prevention of violence against women and children but the funds to continue that work finish up at the end of this year and the findings for the Royal Commission don’t come down until February.

My worry is that some of the momentum that has built up through the Royal Commission and through the funds that have been available in each of the regions may well be lost. I do have concerns, and I think as an organisation that has both response and prevention arms, we can speak out a little more strongly because we don’t have a vested interest in one or the other. We’ve got a vested interest in both.

We’re confident that the Andrew’s Government and Fiona Richardson as the Minister for Prevention of Family Violence are really committed to finding a bipartisan or multi-partisan long-term strategy, which is what you need, and that’s fantastic and I think the intent is there. But what we need to see is that a little bit more front and centre in the Royal Commission and in the media and more front and centre in terms of decisions about funding.

Prevention is a very small percentage of the health budget and prevention of violence against women a tiny percentage next to that, probably 0.02 per cent of the health budget.

How do you tackle this issue when the changes that are achieved are often very incremental? Does it become quite tiring?   

I don’t know if tiring is the word. Perhaps not just for myself but think of my colleagues more generally, working in an organisation where you are dealing with trauma and vulnerability and oppression on a daily basis can be precariously traumatising in itself.

As demand gets higher and higher and our staff are often having to bear the brunt of that where fund increases aren’t available, I think that can be really tough work. You have to work really hard to hold an organisation and to hold staff when you're working in an area that’s so much on the frontline.

Part of the work we do around prevention I think does help our staff because they learn from each other. Our staff that are dealing with crisis on a day to day basis have a really strong sense of, as an organisation, we’re also working to prevent violence against women, so it feels like more than the band aid. It feels like we’re really doing something to make a difference as well. And similarly our staff that are working on prevention have the stories on the ground of the women and children who experience violence, and that inspires and continues their commitment as well.

We’ve shifted in the last five or 10 years into a much clearer view that family violence is preventable. When we first began working in this space 10 years ago it was such a huge overwhelming problem and the thoughts were “how could we possibly prevent something that’s as huge and systemic as family violence” but I think we’ve learned a lot over the last decade about the kinds of strategies that are possible in the workplace, in sporting clubs, in the arts, about how we can prevent violence against women. I think that really keeps you going, that idea that you can make a difference, that if we have a really long-term concerted strategy that looks at the questions of gender equities at their very core, systemically not only attitudes and behaviour towards women, or towards women and children, but also the systems that exist that continue to allow gender inequities to occur, like equal pay or the number of women on boards or in Parliament or leading organisations.

Those kind of areas that say a systemic response is possible if we have a really committed Government working in partnership with organisations and communities that we can bring about change, recognising we’re talking about decades. I think that keeps you inspired rather than being bogged down in the day-to-day.

Each time we hear of another woman who’s died as a result of family violence, and that includes our own clients, it’s very front and centre and really tough to have to deal with that. So for me it’s that kind of “and both”, that really often vicariously traumatising workplace for colleagues on one hand, but inspiring on the other because we’re not only responding to the needs of women and children as best we can but we’re also trying to make a difference so that the circumstances that create violence against women in the home can be eradicated.    

What’s the best advice you’ve ever received?

I don’t know if this constitutes advice per se but it kind of felt like a question that all of us should reflect on and it was “what are you going to do with the privilege that you have?” For me as a white, middle-class, well educated woman, what am I going to do with that privilege to make a difference in the world? It’s a question that was posed to me by a friend and a colleague many years ago and it’s always sat with me. I don’t know that it’s advice but it’s kind of a call to reflection, which is maybe the best kind of advice.