Synapse 2022 Annual Review

AUSTRALIA’S BRAIN INJURY ORGANISATION Annual Review 2022

Contents

Our mission Ensure the rights of people impacted by brain injury by connecting knowledge, policy, services and systems.

Our vision

Our values

Rethink brain injury.

Change society.

• We hold each other steady.

• We build relationships.

• We are problem solvers.

• We remain curious, always.

• We are courageous.

Acknowledgement of Country Synapse respectfully acknowledges the traditional custodians of the lands, seas and waterways upon which Synapse provides its services. We pay our respects to the Elders, past, present and future, and commit to working side by side.

SYNAPSE OVERVIEW CEO’s message

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Our board

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Breaking the cycle of vulnerability

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Brain injury facts and figures

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IMPACT AND ADVOCATE Facing workforce shortages as disability and aged care need grows

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Advocate with impact

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National reach

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Partners

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Advocacy programs

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SUPPORT AND INNOVATE

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Connecting to share and raise awareness

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Key publications

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Community services

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Housing

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Training and employment

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The findings of ADNIP report

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Guddi Way Screen working in the community

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PEOPLE

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AUSTRALIA’S BRAIN INJURY ORGANISATION

Our team

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FINANCIAL SUMMARY

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ANNUAL REVIEW 2022

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CEO’s message

Our board

On our journey, we never walk alone.

We’re strong when we stand with our partners, linking communities and cultures in positive ways.

I remind myself every day how honoured I am to be a part of Synapse. The work we do is of vital importance to the people we serve. This is life-changing work and we are fortunate and proud to play our part in helping those living with brain injury.

We’re ambitious and our commitment remains unwavering.

But at our heart, we exist for community. We are made up of community. Our obligation is to community. We have a vision to “rethink brain injury, and change society”. All our efforts are focused on achieving that vision through strong strategic plans and a culture of collaboration, partnership and accountability.

Through it all, we keep building our connections to the individuals, families, communities and organisations central to Synapse.

Their stories are our stories. We are a part of a community of learning—one that drives us to do better each and every day.

On our journey, we never walk alone. We’re strong when we stand with our partners, linking communities and cultures in positive ways. As we continue to increase our national reach, we bring with us a workforce and network of partners and fierce advocates that reflect our diversity and authenticity. We’re a coalition of voices from within the community.

This year has seen a number of important undertakings and new partnerships, addressing the many issues that often lead to contact between people impacted by brain injury and the justice system.

In partnership with The Hopkins Centre and Griffith University, we completed Assessing the Disability Needs of Indigenous Prisoners (ADNIP).

We delivered the Guddi Way Screen in more communities and participated in the Disability Royal Commission to shed light on institutional human rights injustices in correctional services that affect people living with brain injury.

These collaborations are reflective of the ever-widening network of influence we seek to extend on behalf of people living with brain injury.

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We continue to advocate for issues embedded in statutory policies around adult guardianship, workforce issues and the intersection of brain injury with the criminal justice system.

Our work is far from done. Many of our nation’s social, health and justice systems still tend to misdiagnose brain injury, confusing it for mental illness. We will tirelessly advocate for people living with brain injury and empower them to make their own choices and be heard.

We’re so grateful to the Synapse Board for guiding our path this past year.

From the bottom of our hearts, we also thank the extended Synapse family for the significant part everyone has played in helping us achieve our vision.

That includes our partners, donors and advocacy organisations and, most of all, the community of people living with brain injury who are the reason we get out of bed every morning.

As we always say, it’s our connections that make and keep us strong—just like the synapses in the human brain. Thank you to everyone who believes in what Synapse does and helps us to make a difference in so many lives.

Jennifer Cullen Synapse CEO

Paul Watson Non-Executive Director

Greg Luck Non-Executive Director

Paul Watson is a Director of Berrill & Watson Lawyers and an expert in superannuation and life insurance.

For the last decade, Paul has delivered seminars and workshops for disability support groups, financial counsellors and consumers with the aim of improving the lives of people with a disability, injury or chronic illness. Paul is a current member of the Consumer Law Committee of the Law Council of Australia and was awarded an Honorary Life Membership with Palliative Care Queensland because of the support he provided to the organisation.

Greg Luck holds the CEO position at the Pickwick Group. With over 25 years’ experience in senior executive roles transforming businesses across Australia and in more than 24 countries internationally, Greg is known for his transformational leadership, his innovation and driving cultural change while managing stakeholder expectations and outcomes.

He has been described by his peers as a “visionary, gifted leader and passionate human” who “resonates and motivates all who have the opportunity to work alongside him”. Greg holds a Masters in Business Administration, holds a Bachelor in Vocational Education, is a member of the Australian Institute of Company Directors and was awarded the distinction of Certified CEO by The CEO Institute.

Paul Raciborski Non-Executive Director

Hannah Hiscox Non-Executive Director

Justin Hogg Company Secretary

Paul Raciborski experienced a severe brain injury as the result of a fall in 2003. Since then, he has strived to make a difference for others who have lived through similar experiences. Paul is a disability support worker and supports people with mental health conditions and intellectual and physical disabilities. Before he acquired a brain injury, Paul’s career saw him hold various positions in corporate project management and manufacturing.

Hannah Hiscox is a chartered accountant and registered company auditor with more than 20 years’ professional experience.

Currently a partner in the Audit and Assurances team at Grant Thornton Australia, Hannah audits a portfolio of charities registered with the Australian Charities and Not-For-Profits Commission (ACNC). Hannah holds a Bachelor of Business (Accounting) and a Graduate Certificate in Business (Philanthropy and Non-profit Studies).

Justin Hogg is the Founding Director of the accounting firm, Right Source. He has worked as an accountant in several industries where he managed teams responsible for billiondollar business ventures as well as charities. Through multiple leadership positions and extensive business experience, Justin has gained a unique ability to communicate and relate to people from all walks of life. He is passionate about the not-for-profit space and helping those who help others. As well as the Company Secretary role at Synapse, he serves in the same capacity for several other not‑for‑profits.

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Breaking the cycle of vulnerability

d l i Ch

Cycle-breaking

Our first cultural and social connections come from our family, extending to systems through life.

• Caring parenting support • Positive early health, social & cultural connections

Brain injury can impact you at any stage of life.

You ng Ad ul t

As we develop, our stability can impact our wellbeing, feeding into many areas of life.

• Developing skills through education • Positive cultural, social & health connections help with belonging and identity • Access to employment & housing

Vulnerable experiences

No two brain injuries are the same and how they affect each person can have far reaching influence, for those living with brain injury and people living with someone who has a brain injury.

Each of these can lead to significant developmental consequences in wellbeing.

• Family violence • Child protection risk • Born with FASD

Without the right support, knowledge and opportunities at key milestones of life, people impacted by brain injury can fall into a cycle of vulnerability. When a brain injury occurs, this can affect any number of cognitive functions.

Unprotected home environment can give rise to lack of wellbeing.

• Reduced • Drug & alcohol educational misuse outcomes • Youth justice • Lack of • Lack of housing employability

Brain function changes can alter the life of a person living with a brain injury and those close to them. Some of these changes can amplify vulnerabilities and possibly limit choices and self-determination, leading to individuals living in a cycle of vulnerability.

The gaps and vulnerabilities experienced by people living with brain injury is increased when government systems don’t connect and integrate. People are often subjected to interventions that fail to recognise or adequately address the need that can change someone’s trajectory.

As we age, we are at higher risk of a brain injury. Without proper support, seniors are more at risk of being isolated.

• Drug & alcohol misuse • Family violence/mistreatment • Lack of housing

Early gaps in systems can grow larger in adulthood or a brain injury as an adult can create gaps.

• Family violence • Lack of employability

• Drug & alcohol misuse • Criminal justice • Lack of housing

Vulnerable experiences

People living with brain injury may require additional support to maintain self‑determination & connection.

• Positive cultural, social & health connections help with belonging & identity • Access to housing

Choice & self-determination are limited by how connected we are to our communities.

• Positive cultural, social & health connections help with belonging and identity • Access to employment • Access to housing

ul t

i or Sen

Synapse exists to break the cycle of vulnerability by connecting knowledge, policy, services and systems for people living with brain injury, their families and their communities.

Ad

Cycle-breaking

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Brain injury facts and figures 1 in 45 Australians live with a brain injury Almost three in four people with a brain injury are under 65 One in four brain injury hospitalisations are people aged 15–24 2% of all Australians live with a brain injury

Common causes

Effects

• Falls cause 39% of brain injuries • Motor vehicle and cycling accidents cause 31% of brain injuries • Assaults cause 12% of brain injuries

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• Trouble planning and organising • Memory issues • Struggles with attention and concentration • Trouble with decision making Psychological • • • • •

39%

31%

12%

Low mood and anxiety Panic attacks Clinical depression Risk of suicide Post-traumatic stress disorder (PTSD) • Stress and anxiety • Mental illness Behavioural

Impacts • 30% of Australians • 51% of Indigenous seeking homelessness Australians aged 45–59 support have a disability report a head injury • Head injuries from falls • 42% of adult male in older Australians have prisoners and 33% of adult doubled in the past decade female prisoners have been diagnosed with a • Fall-related injury is six brain injury times more likely to occur in residential aged care than home

Other causes More information about the sources of published statistics is available online. Please scan this QR code to go directly to the webpage: synapse.org.au/key-facts-figures-sources/

Cognitive

• Stroke • Degenerative conditions • Hypoxia/anoxia (lack of oxygen to the brain)

• Brain tumours • Infection or disease • FASD

• • • • •

Personality changes Identity problems Irritability and anger Disinhibition and impulsivity Egocentricity and lack of self‑awareness • Risk of domestic violence

Physical • • • • • • • • •

Fatigue and sleep issues Headaches Pain Epilepsy and seizures Sensory and perception issues Balance issues and dizziness Hearing loss Sexual changes Trouble with communication and speech • Visual impairments

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Facing workforce shortages as disability and aged care need grows Since the beginning of the COVID-19 pandemic, Australia has seen consistent media coverage of the workforce shortages and hardship present across key industries and sectors.

In the disability and aged care sector, these challenges will continue to intensify as our ageing population and growth in demand for the National Disability Insurance Scheme (NDIS) requires our support services to expand.

In June 2021, the National Disability Insurance Agency (NDIA) released the NDIS National Workforce Plan 2021–2025.

This plan stated that, by 2024, around 500,000 NDIS participants will require the support of 353,000 workers. The Committee for Economic Development of Australia (CEDA) also released a report that claimed the aged care sector will face a shortfall of 110,000 direct aged-care workers within the next decade. This means 17,000 more aged-care workers will be needed each year to meet Australia’s growing care needs.

For Synapse to hold true to its commitment of support for anyone affected by brain injury, we must work to overcome workforce shortages. Finding appropriate staff to deliver quality services has never been more critically important.

As a provider and advocate of specialist services to people living with brain injury, we understand that ensuring the right services means having a workforce that has similar lived experience to those with a brain injury. This is especially evident when

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considering the experiences of Aboriginal and/or Torres Strait Islander people.

Synapse has seen undeniable success when employees understand the experiences, both culturally and socially, of the person for which they’re supporting.

We see it every day at our Community Living service where 95 per cent of staff are Indigenous and the residents are culturally understood, are respected and belong.

The NDIS plan recognises that workforce diversity is increasingly important to support choice and control. Yet it also acknowledges Aboriginal and Torres Strait Islander peoples can face additional challenges when trying to join the care and support sector workforce. We need more Aboriginal and Torres Strait Islander peoples as carers to address the cultural, language and understanding needs of a system that cannot adequately care for the number of Aboriginal and Torres Strait Islander peoples seeking its support.

But there are still some critical roadblocks that need to be cleared.

Our Aboriginal and Torres Strait Islander peoples are over‑represented in experiencing the complex issues that also may contribute to brain injuries: domestic and family violence, attempted suicide, mental health concerns, homelessness, and drugs and alcohol misuse. Understanding or having lived these experiences, in a cultural context, is essential for our workers to properly and deeply see, respect and understand a person and their story in order to support and connect with them and what is important to them.

While these experiences are vital components in being able to connect with the people seeking Synapse’s support, they can also lead to Aboriginal and Torres Strait Islander peoples being caught up in the criminal justice system and receiving a record that follows them throughout their life. Last year’s change from a statebased criminal check to a national NDIS screening check has meant the relevancy of a person’s criminal record brings with it many of the systemic and cultural biases that exist in Australian organisations.

We begin to see that systems commonly considered as safeguards in a nonIndigenous context in fact make services culturally unsafe for Aboriginal and Torres Strait Islander peoples. The people we need in the workforce are being denied access to employment and a career by the same system that is in desperate need of their background and unique understanding. This continues the cycle of adverse effects that homelessness and lack of employment can have on the individual and community. If a person loses an appeal contesting their employment suitability, it can be another five years until they can reapply, effectively preventing them from entering the sector.

Our organisation hopes the recognition of this workforce shortfall across the aged care and disability sector will see real steps taken towards resolving the fundamental systematic and human rights issues that restrict Australia’s Aboriginal and Torres Strait Islander peoples from accessing the NDIS and working in the industry.

risk assessment in place and heavy compliance to safeguard and protect people from abuse and neglect, we will be able to live up to our responsibilities in these communities when considering criminal history in the context of specific and evidenced risk toward people with disability. If these requirements are met, then giving opportunities to Aboriginal and Torres Strait Islander peoples to care for people with disability, or who are aged, in their communities should be preferenced, not punished.

“If we want people to feel safe to access services, we need to extend the skills and knowledge we consider essential far beyond a traditional disability lens.”

Cultural safety is the critical ingredient that attracts, enables and retains a strong workforce. However, cultural safety is not created; it is experienced. It is not limited to creation of identified employment opportunities. It is not limited to Indigenous artwork on a website. Yet a regulation that dictates that workforce be layered with cultural bias before one even secures employment has, in effect, removed that valuable experience through ill-informed and misunderstood bias rather than seeing knowledge and experience that can never be trained. These are the skills and knowledge it takes to design and deliver culturally informed and respectful services.

Attracting and retaining a strong Aboriginal and Torres Strait Islander workforce requires a great deal more intentional commitment, understanding and support than for a non-Indigenous workforce. We need to address the equity in employment opportunities and access to services, not only equality.

Adam Schickerling National Director—Strategy and Engagement

The hard reality is that some of these challenges and barriers are caused by systemic biases, which don’t take Aboriginal and Torres Strait Islander peoples’ experiences into consideration.

Synapse believes that with a strong

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Advocate with impact Every person is different, and every brain injury is different. That is our starting point when we begin to advocate and create the necessary impact for any person living with a brain injury.

The heart of our advocacy mission comes from harnessing our resources, skills, expertise and lived experiences to promote change. Talking about it is not enough.

We take practical approaches and cast a brain injury and cognitive impairment lens across all of our support, advocacy and impact work.

Synapse considers every intersection of life where brain injuries can introduce challenges. This shapes the way we seek to create meaningful impact. Taking a holistic approach that recognises how a brain injury affects various functions of life and identity helps us to find the right pathways and solutions.

That lens allows us to see the individual needs in front of the larger societal picture. The diversity of ways in which brain injuries impact people’s lives means there’s no cookie-cutter approach to how to best support their needs.

But we are still acutely aware that brain injury is significantly under-diagnosed in our community. The inherent difficulties in identifying brain injury, along with mental health misdiagnoses, are continuing issues that need resolving. Creating better understanding around brain injury is the first step to addressing this problem.

Disconnection is the enemy we face.

Our role is to make the right connections— whether that involves funding, social interaction, employment or any other requirement—to help people living with brain injury from falling into the cycle of vulnerability.

If a person acquires a brain injury, there are many types of cognitive changes that can occur. These changes might lead to homelessness, criminal charges, lack of employment, and even violence against self and/or others. This cycle of vulnerability then goes directly to basic human rights and the idea of self and identity.

National reach Services

Working with communities

The passion we have for serving our community is best embodied and reflected in the range of services and programs we offer to people living with brain injury, their families, carers and support networks.

We connect with people living with brain injury and their communities by providing support and engaging with them to identify their service needs at individual and community levels.

Needs differ from person to person.

Meeting individual requirements depends on Synapse providing and operating specific services and programs within our networks, including: • • • • • • • • • •

information and referral support coordination advocacy support and housing impact and evaluation Synapse peer support hospital and rehabilitation assessment, screening and planning training and education information and knowledge.

System and individual advocacy Our national advocacy works to embed change in policy, services and systems through all levels of society to ensure those living with brain injury are systematically heard, empowered and represented.

Partnerships Our engagement with government agencies and other organisations builds knowledge and support systems for those living with brain injury. We teach our partners how to respond and develop their support capabilities.

Communities Services

Where Synapse has a presence

Cairns

Queensland • Brisbane • Sunshine Coast • Cairns New South Wales • • • • •

Parramatta Gosford Dubbo Mid-north Coast region Hunter & New England region

Western Australia • Perth

Sunshine Coast Brisbane

Perth

Paramatta

Victoria • Melbourne

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Partners

Advocacy programs

We know we’re only one piece of a larger puzzle.

As Australia’s peak body for brain injury, we take our responsibility for wide-scale advocacy on behalf of our community very seriously.

Synapse partners with philanthropists, medical institutions, government agencies and academic organisations through multiple universities across Australia.

Our partners provide perspectives and evidence that shape how we deliver services and influence national and global conversations around brain injury.

• • • • • • • • • • •

The Hopkins Centre, Griffith University James Cook University Flinders University Monash University Perron Institute for Neurological and Translational Science Curtin Health Innovation Research Institute Western Sydney University Latrobe University Edith Cowan University Deakin University The University of Queensland

Funding bodies We wouldn’t be able to provide our range of support services to people living with brain injury without the belief and support from our funding, industry and research partners.

• Federal Department of Social Services • Federal Department of Health (My Aged Care) • NSW Government Department of Health • NSW Government Department of Community & Justice • NSW Government Insurance & Care (iCare) • National Injury Insurance Scheme Queensland (NiiSQ) • Queensland Government Department of Seniors, Disability Services and Aboriginal and Torres Strait Islander Partnerships • National Disability Insurance Agency (NDIA) • Private investors and trusts

The rights, interests and needs of people living with brain injury require a voice that speaks in equal volumes of knowledge and passion. Synapse advocates in a systemic way to ensure people living with brain injury are represented and connected to the various agencies, departments and organisations that influence their lives.

We participate in numerous reference groups, including: • iCare • Accessible Transport • NSW Civil and Administrative Tribunal Guardianship Advisory Panel • Electoral Commission Advisory Panel • NSW Women’s Domestic Violence Court Advocacy program.

The past year saw Synapse hold training sessions for the Council of the Australian Tribunals staff and members to help them assist people with cognitive disability.

A special thanks to: • The Hopkins Centre, Griffith University, Queensland • Australian Government’s Healthdirect • Clayton Utz • Deborah Hatzi, donor • The SJ Hill Foundation, donor • Helen Stevenson, donor • Trevor Kelly, donor and former Headwest member • Geoff Ross Endowment Giving Fund • Healthline

Individual advocacy Our individual advocacy service in NSW provides self-advocacy support for people with disability and advocacy support for carers and guardians.

We support them in asking for more suitable services, navigating systems and making complaints, and we represent their needs to government agencies, service providers and hospitals.

NDIS appeals service The NDIS system can sometimes be difficult to navigate. Part of our role in supporting those living with brain injury is the NDIS appeals service we offer for anyone who believes they have received an unsatisfactory or inappropriate NDIS outcome or have been denied access altogether.

Our expertise allows us to effectively advocate for individuals through the appeals process and we have achieved successful outcomes for several applications.

Synapse advocated for more than 350 individuals

22%

How are we advocating for our community?

Services issues/NDIS Accommodation issues Financial issues Justice issues Social and family issues

15% 27%

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Support and innovate Dignity and self-worth are rights for every individual, including people living with a brain injury.

Synapse works across all relevant systems and political divides to ensure people living with brain injury enjoy the same opportunities, human rights, self‑determination and identity afforded to all members of society. Protecting and advocating for those rights is a catalyst for fighting against the isolation and cycle of vulnerability that often results from a brain injury.

Our innovative approach is intersectional in that we look to provide support across key needs and services such as housing, training, social and industry support, and access to allied health.

Strength is in community. Synapse will continue to build our community to help create change and make a difference in the lives of those we serve.

Connecting to share and raise awareness Credible information is gold. Whenever someone living with brain injury is facing challenges or asking questions, the ability for them, their family and carers to be fully informed allows a better understanding of opportunities and options.

Our services form a crucial part of Synapse’s strategy to raise awareness and share connections.

Synapse aims to create the right informational support networks and relationships between our organisation, referral services and people living with brain injury.

Information and referral Our dedicated information and referral team help people manage the effects of their brain injury, navigate services, access the NDIS, obtain information about brain injury, and connect with others impacted by brain injury. We also support, train and educate service providers and professionals.

More importantly, our information and referral team allow those living with brain injury to be heard. Information is a twoway street, and our team learns and grows every day through the voices they hear.

The national information line is available to anyone affected by a brain injury and we respond to enquiries through our website, by email and in person.

The directory connects people needing help with providers in four categories: • • • •

community and culture daily life and family health and rehabilitation support and care services.

Under each category lies a wealth of providers, resources and services, including: • • • • • • • • • • • • • •

drug and alcohol centres employment services Indigenous services homeless services equipment grief and bereavement transport and fitness programs physiotherapists speech therapists other allied health neuropsychologists accommodations advocacy case management.

What are people asking about?

Service directory Finding the right service provider can be very difficult at times. Our service directory has more than 650 provider organisations from across Australia.

In the past 12 months, more than 2,500 people looked for providers on Synapse’s directory.

Our curated service directory helps people living with brain injury to find local health and service providers with the experience and qualifications to address their various needs.

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9% 4%

3%

20%

40% 24%

40% information 24% peer support and other services 20% advocacy and NDIS appeals 9% support coordination and housing 4% ageing 3% training

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Key publications As the national body for brain injury, we create key publications to support the journey of living with a brain injury and raise awareness of its impacts.

ABI: The Facts Our second edition of ABI: The Facts is a practical and easy-tounderstand guide that steps the reader through every stage of the brain injury journey. Our nationally recognised flagship publication ensures current and evidencebased information is at the fingertips of anyone who wants to learn more about brain injury.

Community services Synapse Reconnections support groups Living with a brain injury can lead to social isolation, which can be an indicator for depression and other mental health issues.

Synapse connects carers and family members of people living with brain injury, giving them a space to discuss the day‑to‑day challenges and victories with people who understand their journeys.

Our peer support community connects people living with brain injury to share experiences, socialise, and feel understood and supported.

We hosted national online events and in-person gatherings in Queensland, Western Australia and New South Wales.

Recovering from a Brain Injury This publication answers the first questions someone may have when their loved ones are admitted to hospital with a brain injury. It outlines what to expect in the first few days and weeks of the brain injury recovery journey.

My Weekly Schedule My Weekly Schedule is a simple planner on a fridge magnet with a whiteboard marker. It builds independence and greater autonomy by helping people living with brain injury to develop their memory and organising skills.

Come spin a Yarn about the brain This publication takes the reader on a journey about what brain injury is, how to recognise the possible social, mental, physical and emotional struggles a person may exhibit, and how others can help.

Originally developed for Aboriginal and Torres Strait Islander peoples, it is available in English and Kriol.

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BrainBank podcast

BrainBank panel

In 2021, we launched our BrainBank podcast series where we answered our community’s frequently asked questions.

The podcast covers a range of topics—from navigating life with a brain injury, to love, employment, social connections, housing and more.

Our peer connection panel draws on people across Australia who are living with brain injury as well as their family members and carers. The panel delivers a forum where people can connect in a safe, reassuring way to share their experiences, provide valuable insight and encourage each other on their journeys.

With more than 1,000 episode downloads, BrainBank has succeeded in providing a safe space for people to share their lived experiences, challenges and triumphs.

The podcast has proven to be a dynamic community-building exercise across so many levels.

It’s another way Synapse is delivering peer-to-peer support for people living with brain injury.

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Housing We know many people living with brain injury fall through the cracks for a range of reasons—such as limited access to support, mental health issues, substance addictions, a lack of awareness from support providers, difficulty getting and keeping jobs, and trouble with managing home life.

Memory and other cognitive challenges can make it difficult for people living with brain injury to uphold their responsibilities in a tenancy agreement—such as paying bills on time—resulting in the loss of housing.

Without a stable address, people often struggle to find and keep a job.

Synapse recognises that there are very few housing models available to people with complex needs. Our approach to providing housing options for people living with brain injury considers who the person is,

Domestic and family violence

Incarceration

• 69% identified family and domestic violence as the main reason for accessing homelessness services • Perpetrators of intimate partner violence are twice as likely to have sustained a brain injury • 40% of domestic and family violence victims over a 10-year period sustained a brain injury

• Disadvantage and support needs are highly prevalent among people in prison, particularly: mental health conditions (40%), cognitive disability (33%), problematic alcohol or other drug use (up to 66%), and past homelessness • 42% of adult male prisoners and 33% of adult female prisoners have been diagnosed with a brain injury • Former prisoners in stable housing are much less likely to reoffend than those who are homeless or in unstable accommodation

their mental health needs, their risk factors, and the circumstances enabling or disabling their chances for success.

Housing services Community Living Initiative

National Reconciliation Week

We want to support people to create the life they want, so we work with experts (such as homelessness shelters and the criminal justice system) that help us see the big picture. When we understand what contributes to and causes the problem, we can design our supports around it with more effective outcomes.

Our Cairns community is a great example of how we work with community partners to create real and better housing options for Aboriginal and Torres Strait Islander peoples impacted by brain injury and disability. This is just one of our many housing approaches, because Synapse recognises that how we live, what keeps us safe and what keeps us connected can be as different for each person as their brain injury.

This year, we again hosted National Reconciliation Week celebrations in Cairns.

We brought together people from across the communities and institutions who need to work together to provide a more integrated life for Aboriginal and Torres Strait Islander peoples living with brain injury.

Statistics Indigenous Australians • 28% of the total homeless population are Indigenous Australians • 4 in 10 Indigenous homeless peoples are aged 18 or under • Those in remote communities are three times more likely to acquire a brain injury than in major cities

Young people in residential aged care (YPIRAC) • Every year 2,000 people under 65 enter residential aged care • 1,100 long-stay NDIS participants are stuck in Australian hospitals at a cost of $860m per annum • Cohorts at increased risk of unsuitable housing include young people, women and Indigenous Australians Source: https://synapse.org.au/key-facts-figures-sources/

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Training and employment

The findings of ADNIP report

Workplace training

Yarn Up cards

Synapse’s specialised brain injury awareness training is unique in Australia, informed by more than 35 years’ experience working with people living with brain injury. Our foundational learning areas spread awareness of brain injury and provide organisations with a sound understanding of brain injury, its impact and effects, and how to support someone living with a brain injury.

This year we continued to develop the Yarn Up cards to assist in the conversation about employment for Aboriginal and Torres Strait Islander peoples. Yarn Up cards were developed under the guidance of partners and several Indigenous communities in Western Australia. The cards are culturally informed, featuring language, imagery and artwork that has been generously contributed by the communities for which they are intended, ensuring local knowledge and culture remains at the forefront.

Identifying and supporting Aboriginal and Torres Strait Islander prisoners with disability

Our training is tailored to individual organisations’ needs and is suitable for: health and support providers, government departments, employers and employment agencies, and schools and education sector staff. We deliver this training through eLearning, workshops and webinars.

The Yarn Up cards raise awareness of the hidden impacts of living with a brain injury. They equip organisations assisting Indigenous job seekers by providing a tool to better articulate and understand the support they may need.

Synapse partnered on the Assessing the Disability Needs of Indigenous Prisoners (ADNIP) summary report with Griffith University, The Hopkins Centre and Menzies Health Institute Queensland. We collaborated with Aboriginal and Torres Strait Islander peoples to examine how disability is assessed in Aboriginal and Torres Strait Islander prisoners and ex-prisoners.

The project aimed to identify the current disability assessment methods (and their gaps) and find services to support Aboriginal and Torres Strait Islander prisoners in their post-release transition into society.

What the project involved

Key findings

We began with a literature review to evaluate the tools, processes and approaches being used to identify disability and link Aboriginal and Torres Strait Islander prisoners to rehabilitation and treatment.

The report found a number of areas where better knowledge and programs can ensure prisoners with disability are treated with dignity during and after their sentence term.

This was followed by interviews with stakeholders across different levels and sectors to understand the prison journey and process for community reintegration.

The final stage was community consultation. We directly engaged with Aboriginal and Torres Strait Islander communities to seek input into solutions that respond to the specific needs of Aboriginal and Torres Strait Islander prisoners and ex-prisoners with disability.

The delivery of the ADNIP report was the result of successful collaborations between Aboriginal and Torres Strait Islander peoples, corrective services and our research partners.

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• There is a general lack of research into disability identification tools and processes in prisons (both for Indigenous and non-Indigenous prisoners).

• No evidence was found that cultural relevance of assessment tools is considered in prison, which is exacerbated by the general lack of culturally validated tools.

• Identification of disability in prison is reliant on self-reporting, which does not match cultural ways and is prevented by the likelihood of apparent or potential discrimination.

• Assessment for disabilities on entry to prison is usually limited to ‘visible’ disabilities, resulting in an underdiagnosis of more hidden disabilities, particularly if they are not self-reported or unknown.

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• Mental health and intellectual disability are more likely to be assessed and referred for services than other disability types.

• Different types of cognitive impairment are poorly differentiated.

• Available knowledge about FASD and hearing loss focuses on paediatric populations so the impairments are even more hidden and poorly recognised in adults in the prison setting.

• There is a lack of time, resources and training for staff to conduct a proper assessment in terms of disability, mental illness and cultural sensitivity.

• There is a requirement for the development of a workforce with adequate knowledge and skills about disability and experience of culture, with sufficient capacity to deliver an individualised response.

• The system must provide a more integrated approach to timely information management and access to appropriate resources.

Guddi Way Screen working in the community

• Most high-priority solutions are related to culturally appropriate disability assessment and support including: › a need for more Aboriginal and Torres Strait Islander peoples in the prison workforce (across all types of positions within the prison and following release) › increased access to cultural activities in prison (including connection to culture through Elders programs and yarning circles; cultural activities) › better connection to family for prisoners (in prison and in preparation for release) › culturally appropriate assessment methods (including more cultural support during assessments; and making holistic assessments inclusive of the person’s history and family knowledge) › Aboriginal and Torres Strait Islander peoples-led reintegration supports (coordinated cultural and reintegration supports).

We work with state and national organisations and agencies to educate and create foundations to improve the cultural capacity and understanding of brain injury.

In particular, we aim to aid more culturally responsive services for Aboriginal and Torres Strait Islander peoples with brain injury.

The Guddi Way Screen is an online, secure and automated platform built from evidence and stakeholder consultation.

The screen identifies cognitive impairment and needs within a culturally informed and validated process.

Research process Empirical literature review on tools and processes Scoping and engagement

Jurisdictional fieldwork interviews

Community consultations focus groups

Grey literature review of examples in practice

Process mapping analysis

• Evidence-based tools • Effective processes • Exemplary practices

• Current processes and practices • Challenges and barriers

• Levers for change • Targets for improvement

Recommendations

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AUSTRALIA’S BRAIN INJURY ORGANISATION

Behavioural engineering analysis

Nominal group technique

• Priority solutions • Preferred practices

This is a great example of the way Synapse uses its research and evidence to give a voice to individuals and communities often frustrated by mainstream approaches that are culturally inappropriate and often harmful.

Synapse has undertaken significant work over recent years to build the tool into an online, secure and automated platform to improve accessibility. This interface allows a suitably trained person to undertake the screening of a person face-to-face and in real time, with the immediate generation of informative reports. These are intended to guide understanding of the likely impacts of cognitive difficulties on a person as well as identifying necessary referrals, should further assessment or diagnosis be necessary.

If someone is flagged with possible cognitive impairment by the Guddi Way Screen, they can be referred to GPs, mental health professionals and supporting community organisations to be diagnosed and receive care, tools and systems to help them live positively with their brain injury.

The Murri Court in Brisbane and Richlands are using the Guddi Way Screen for convicted Aboriginal and Torres Strait Islander peoples to help the Magistrate understand a person’s capacity and how the court can support them better through the Murri Court process. Since it has been used by the court, 71 per cent of participants were flagged with impairments of at least one cognitive domain—primarily domains affecting social interaction, self-management and learning.

Capturing cognitive impairments this way can help us understand why some people fail to meet the requirements within judgement from our judicial systems.

As a result, not a single person that had participated in the Guddi Way Screen had ended up with a custodial sentence to date.

The word ‘Guddi’ means ‘Come Home, Come Heal, Come Rest’ in the traditional language of the Kuku Yalanji peoples of Far North Queensland.

Being online, the interface ensures accessibility across Australia while safeguarding the cultural integrity of the screen and the quality of the screening process, scoring and reporting.

Assessments span orientation, attention, language, memory, visuospatial skills, praxis and executive function.

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Our team The heart of our organisation

Synapse employees are committed and deeply passionate about seeing people living with brain injury live meaningful and independent lives. Our people reflect the diversity of the communities we serve, the lived experiences we support, and the environments in which we operate.

WHAT WE ACHIEVED IN 2021–22 Developed clearer career pathways for employees as well as pathways to leadership Articulated a clear professional development annual budget allocation for each of our employees to strengthen our commitment to investing in and developing our employees Continued to promote opportunities for on-the-job learning, including shadowing, higher duties, secondments and cross‑functional projects

30%

of Synapse employees identify as Indigenous

Overall increase in employees

Began work on our Employee Value Proposition (EVP), setting the scene for pulse surveys and an employee experience survey to add to this body of work in this financial year Investigated enhancing current human resources systems to provide more strategic metrics and assist with forward planning to better support current and future Synapse employees

who’ve identified they have lived experience with brain injury

64%

of Synapse employees are female and 36% are male

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91%

know how their work contributes to Synapse’s vision*

feel accepted and respected in the workplace* *Based on recent employee pulse survey results.

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Freecall: 1800 673 074 Email: info@synapse.org.au synapse.org.au