At the risk of sounding alarmist, the risk of yet another high profile death of a child known to child protection authorities is just around the corner. How can I feel so secure in saying this?
News media are beginning to report the worrying trend of major cutbacks in funding. These inevitably lead to layoffs and the reduction of resources. Fewer child protection workers struggling with systems where there are fewer supports to offer families. This leads to the choice of apprehending a child where supports may have kept a child in the family or, in the alternative, simply determining that only the most serious cases will have files opened (and thus the hope that the child will make it through).
There are those, such as the NCCPR who say that only focusing on real cases of neglect or abuse may be a good thing. They might argue that too many cases are being opened and far too many children apprehended - put the resources against sustaining families and apprehend fewer children. They might suggest that is cheaper and better for society. One doubts that NCCPR spends much time at the front line trying to make the apprehension decision. But, they have a point that resources need to be used wisely and cases opened that really need intervention. If only we, as a society, could agree on that and avoid forcing social workers to make those decisions knowing that limited resources are available.
As Wotherspoon et al., note in a recent article on presenting infant mental health concerns to the courts, many of the interventions that we are using with families are not necessarily effective. Not enough evidence based resources are generally available that recognize the intense and long term supports that many families need. It is not enough to be critical of the apprehensions if you are also not willing to support the funds needed to actually make a difference in families while trying to keep the children with their parents.
Three articles in the last few days tell us that resources are getting tighter. An Australian writer today notes the problems of burnout in CPS workers (http://www.eurekastreet.com.au/article.aspx?aeid=24265).
CommunityCare.co.uk reports today, "All of Derbyshire Council's social care workers have been given the opportunity to apply for voluntary redundancy or early retirement in an attempt to save £84m following government spending cuts" http://www.communitycare.co.uk/Articles/2010/11/29/115904/council-offers-social-care-workers-voluntary-redundancy.htm
Another report from another area of the UK notes "Around 300 children's services posts are at risk in Cumbria as the county council braces itself for a raft of cuts to government grants." http://www.cypnow.co.uk/news/1043844/Cumbria-childrens-services-jobs-risk/
These cuts in the UK will affect a broad range of social workers and supports to families. Will the public stand in support of child protection when the next high profile death occurs looking to the politicians and say it was their responsibility because they cut so many resources? One doubts it!
Postscript:
The Representative for Children and Youth in British Columbia today issued a report on the progress from the Hughes Commission of Inquiry. It is not flattering but it also emphasizes how the economy adds to the challenges of child protection. The commissioner states, "Difficult economic times can mean harsher realities for many of B.C.’s families. Poverty will deepen for some, unemployment rates may climb, and previously successful families may struggle. Social services may be required more often, and community supports may disappear. Stagnant or decreasing budgets will not be able to address the needs of additional children and families" (p. 17).
The adage of doing more with less comes to mind - the recipe for one of those high profile deaths.
The full B.C. report can be found at http://beta.images.theglobeandmail.com/archive/01037/Final_Report_of_im_1037667a.pdf
Monday, November 29, 2010
Tuesday, November 16, 2010
Crisis in child portection
An Australian professor writing in the Sydney Morning Herald yesterday has again highlighted problems that are facing child protection there but the themes are familiar ones throughout the western world:
* under staffing
* need for more education and training
* weak management
* failure to recognize the workers
* high caseloads
These themes are seen in Canada, the UK, USA, New Zealand and elsewhere. Yet, government seems helpless to solve the problems. This may be a function of the child protection model but we may also have to ask some very challenging questions. Are we simply trying to protect too broad a range of problems and families with resources that we are not prepared to fund? In other words, are we simply saying that we have broadened the definition of who should be protected far beyond what we are willing to pay to address? Therefore, has the burden of the child protection system been expanded so far that success is virtually impossible in a broad way?
The ongoing saga of inquiries into the child protection systems suggests so. A redefinition of who needs protection is required but there is nary a politician who may be up to the task. Who, after all, wants to say that we should stop protection for families because we are going to narrow the definition of who is deemed bad enough for services?
Yet, by expanding the definitions of who should get intervention beyond what we can afford to support, we are saying that we will generally do a poor job across large portions of the caseloads. There are only so many cases that any worker can do well.
The social work profession should be leading this debate. With the many political mine fields that come with it, however, is it any wonder that there are few voices who suggest anything other than fewer cases per worker, hiring more workers (an increasingly scarce resource) and increasing funding (with government finances also an increasingly scarce resource).
These are just a few of the very difficult questions that need asking. It will be interesting to see what the Munro commission in the UK ultimately comes up with. Prof. Munro is in the challenging position of trying to suggest a direction for a child protection system that has been under siege in that country for years.
There is a need to challenge the very basic underpinnings of our present child protection systems. It will take a very brave leader indeed to do that.
The Australian article can be found at http://www.smh.com.au/opinion/politics/staff-crisis-at-the-heart-of-child-protection-problems-20101115-17u48.html
* under staffing
* need for more education and training
* weak management
* failure to recognize the workers
* high caseloads
These themes are seen in Canada, the UK, USA, New Zealand and elsewhere. Yet, government seems helpless to solve the problems. This may be a function of the child protection model but we may also have to ask some very challenging questions. Are we simply trying to protect too broad a range of problems and families with resources that we are not prepared to fund? In other words, are we simply saying that we have broadened the definition of who should be protected far beyond what we are willing to pay to address? Therefore, has the burden of the child protection system been expanded so far that success is virtually impossible in a broad way?
The ongoing saga of inquiries into the child protection systems suggests so. A redefinition of who needs protection is required but there is nary a politician who may be up to the task. Who, after all, wants to say that we should stop protection for families because we are going to narrow the definition of who is deemed bad enough for services?
Yet, by expanding the definitions of who should get intervention beyond what we can afford to support, we are saying that we will generally do a poor job across large portions of the caseloads. There are only so many cases that any worker can do well.
The social work profession should be leading this debate. With the many political mine fields that come with it, however, is it any wonder that there are few voices who suggest anything other than fewer cases per worker, hiring more workers (an increasingly scarce resource) and increasing funding (with government finances also an increasingly scarce resource).
These are just a few of the very difficult questions that need asking. It will be interesting to see what the Munro commission in the UK ultimately comes up with. Prof. Munro is in the challenging position of trying to suggest a direction for a child protection system that has been under siege in that country for years.
There is a need to challenge the very basic underpinnings of our present child protection systems. It will take a very brave leader indeed to do that.
The Australian article can be found at http://www.smh.com.au/opinion/politics/staff-crisis-at-the-heart-of-child-protection-problems-20101115-17u48.html
Sunday, November 14, 2010
Adoption
I have counseled children who have been adopted, their parents as well as biological parents who have lost their children.
Often, I am struck by what adoptive parents are not told. They are expected to take on the responsibility for raising a child who has frequently suffered in pre-adoption periods either through unhealthy pregnancies, attachment problems, neglect and abuse - or all of the above. Somehow, we expect adoptive parents to take on these children with one hand tied behind their backs as they only get to learn about what happened to the child as behaviors emerge.
I have regrettably even had cases where the truth about how bad it was for the child pre-adoption was not only withheld but downright misrepresented. In a letter to the editor of The Guardian newspaper in the UK, a magistrate has very nicely summed up the problem with this approach. She writes:
"You write in your editorial that parents who adopt "must be offered support" and that "children who are removed from dysfunctional homes need support for longer than is currently provided". I would like to suggest that using the term "support" in this context is to underplay the serious psychological damage which is the consequence of the "extreme abuse or neglect" suffered by 71% of those adopted, to quote again from your editorial. Where there is psychological damage, it is not support which is required, but serious therapeutic assessment and intervention of the sort offered by trained child psychotherapists.
We should not expect adoptive parents to provide psychotherapeutic treatment for traumatised children. We should be truthful about the extent of the trauma. We need to provide adequate finance for adopted children – and their adoptive parents – to be given therapeutic resources to address the complex issues involved. The long-term savings to the Exchequer would be considerable. Early intervention is well-known to obviate or reduce the need for future costly input." http://www.guardian.co.uk/theobserver/2010/nov/14/big-issue-adoption-child-welfare
The research increasingly tells us that early brain development has broad scale implications for life - be it school, relationships, family life, recreational activities - and that these are life long impacts. As a side note, these impacts are affecting people's capacity to even be successful with their careers as adults.
Given how broad ranging this research, why would we take a known vulnerable population, children being adopted from child protection, for example, and not do all that we could to focus on building as much brain strength as possible? As the magistrate suggests, that requires significant intervention over time.
As government budgets get cut, short term therapeutic interventions become fashionable. With this population, they don't work. One only has to look at the work of Dr. Bruce Perry to see this (his books should be essential reading for anyone who works with this population). The work of Terry Levy and Mike Orlans also shows this.
Adoption is only part of the solution but in the western world it has too often been seen as THE solution.
Often, I am struck by what adoptive parents are not told. They are expected to take on the responsibility for raising a child who has frequently suffered in pre-adoption periods either through unhealthy pregnancies, attachment problems, neglect and abuse - or all of the above. Somehow, we expect adoptive parents to take on these children with one hand tied behind their backs as they only get to learn about what happened to the child as behaviors emerge.
I have regrettably even had cases where the truth about how bad it was for the child pre-adoption was not only withheld but downright misrepresented. In a letter to the editor of The Guardian newspaper in the UK, a magistrate has very nicely summed up the problem with this approach. She writes:
"You write in your editorial that parents who adopt "must be offered support" and that "children who are removed from dysfunctional homes need support for longer than is currently provided". I would like to suggest that using the term "support" in this context is to underplay the serious psychological damage which is the consequence of the "extreme abuse or neglect" suffered by 71% of those adopted, to quote again from your editorial. Where there is psychological damage, it is not support which is required, but serious therapeutic assessment and intervention of the sort offered by trained child psychotherapists.
We should not expect adoptive parents to provide psychotherapeutic treatment for traumatised children. We should be truthful about the extent of the trauma. We need to provide adequate finance for adopted children – and their adoptive parents – to be given therapeutic resources to address the complex issues involved. The long-term savings to the Exchequer would be considerable. Early intervention is well-known to obviate or reduce the need for future costly input." http://www.guardian.co.uk/theobserver/2010/nov/14/big-issue-adoption-child-welfare
The research increasingly tells us that early brain development has broad scale implications for life - be it school, relationships, family life, recreational activities - and that these are life long impacts. As a side note, these impacts are affecting people's capacity to even be successful with their careers as adults.
Given how broad ranging this research, why would we take a known vulnerable population, children being adopted from child protection, for example, and not do all that we could to focus on building as much brain strength as possible? As the magistrate suggests, that requires significant intervention over time.
As government budgets get cut, short term therapeutic interventions become fashionable. With this population, they don't work. One only has to look at the work of Dr. Bruce Perry to see this (his books should be essential reading for anyone who works with this population). The work of Terry Levy and Mike Orlans also shows this.
Adoption is only part of the solution but in the western world it has too often been seen as THE solution.
Tuesday, November 9, 2010
Paying for Sterlization
Child protection, by its very nature, will enter a family and feel like a divisive force to many. This may be true whether the child remains in the home or not. Parents being told that things must change - and being so told by powerful outsiders - can naturally garner some resistance.
For parents who are faced with very large struggles (addiction, serious domestic violence, extremes in poverty, mental illness to name the big ones), child protection often means that their children will be taken from them. An incapacity to make some fairly significant improvements will mean that several will lose their children through permanent guardianship orders or termination of parental rights. Those children will grow up in foster or adoptive homes with varying degrees of success or failure.
Cat McShane, writing in last Sunday's Guardian newspaper in the UK, spoke about Project Prevention. This is a very controversial effort by an organization to essentially stop drug addicts from procreating. As it says on its web site, "Project Prevention offers cash incentives to women and men addicted to drugs and/or alcohol to use long term or permanent birth control." Those who believe that there is a morality to ending the inter generational cycle of dysfunctional families will find some solace in this approach. Critics argue that the project simply pays addicts money to buy drugs in exchange for their fertility - an exchange that some might see as a pretty cheap exchange but not unlike the desperate exchanges that addicts will make many times in their lives.
Those who work in child protection will see some merit in the exchange as they go about their daily work with children affected in utero by alcohol and drugs as well as those who have come to live in the utter chaos of their parent's attempts to survive from one fix to the next.
McShane's column shows that addicts can turn their lives around and go on to become successful parents. He perhaps dismisses too easily the costs being paid by the children born into addiction. His stories of hope are welcome but so must also be the reality for the children who live with the legacy of their parent's addictions.
This is a tough moral debate - pay for avoiding the huge costs to society arising from caring for these children or prevent the births in the first place. While Project Prevention is voluntary, one is reminded of prior efforts by society to prevent unfit parents from giving birth. It reminds me of the eugenics movement where society sterilized thousands of mentally retarded people in order to ensure that they did not have children. While these were forced sterilizations, the moral judgment of who is fit to have a child and who not is a driving force in both.
The other side of the coin is seen in families who adopt children from the system. As someone who has worked with adoptive families, I am struck by the degree to which they are unprepared to deal with the challenges of children born into abuse, neglect and addiction. Thus, another Guardian article last weekend by Tracy McVeigh was not surprising as the challenges faced by these families was outlined - greater challenges than expected; not being told the full truth about the child and not having the full range of supports needed for the challenges being faced. This article is worth a read
http://www.guardian.co.uk/society/2010/nov/07/parents-adopt-child-abuse-support?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+socialservicesnews+%28Social+Services+News+from+IRISS%29
McShane's article is also worth a read as it is thought provoking. You can find it at http://www.guardian.co.uk/lifeandstyle/2010/nov/07/families-divided-by-the-state?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+socialservicesnews+%28Social+Services+News+from+IRISS%29
You can find Project Prevention at http://www.projectprevention.org/
For parents who are faced with very large struggles (addiction, serious domestic violence, extremes in poverty, mental illness to name the big ones), child protection often means that their children will be taken from them. An incapacity to make some fairly significant improvements will mean that several will lose their children through permanent guardianship orders or termination of parental rights. Those children will grow up in foster or adoptive homes with varying degrees of success or failure.
Cat McShane, writing in last Sunday's Guardian newspaper in the UK, spoke about Project Prevention. This is a very controversial effort by an organization to essentially stop drug addicts from procreating. As it says on its web site, "Project Prevention offers cash incentives to women and men addicted to drugs and/or alcohol to use long term or permanent birth control." Those who believe that there is a morality to ending the inter generational cycle of dysfunctional families will find some solace in this approach. Critics argue that the project simply pays addicts money to buy drugs in exchange for their fertility - an exchange that some might see as a pretty cheap exchange but not unlike the desperate exchanges that addicts will make many times in their lives.
Those who work in child protection will see some merit in the exchange as they go about their daily work with children affected in utero by alcohol and drugs as well as those who have come to live in the utter chaos of their parent's attempts to survive from one fix to the next.
McShane's column shows that addicts can turn their lives around and go on to become successful parents. He perhaps dismisses too easily the costs being paid by the children born into addiction. His stories of hope are welcome but so must also be the reality for the children who live with the legacy of their parent's addictions.
This is a tough moral debate - pay for avoiding the huge costs to society arising from caring for these children or prevent the births in the first place. While Project Prevention is voluntary, one is reminded of prior efforts by society to prevent unfit parents from giving birth. It reminds me of the eugenics movement where society sterilized thousands of mentally retarded people in order to ensure that they did not have children. While these were forced sterilizations, the moral judgment of who is fit to have a child and who not is a driving force in both.
The other side of the coin is seen in families who adopt children from the system. As someone who has worked with adoptive families, I am struck by the degree to which they are unprepared to deal with the challenges of children born into abuse, neglect and addiction. Thus, another Guardian article last weekend by Tracy McVeigh was not surprising as the challenges faced by these families was outlined - greater challenges than expected; not being told the full truth about the child and not having the full range of supports needed for the challenges being faced. This article is worth a read
http://www.guardian.co.uk/society/2010/nov/07/parents-adopt-child-abuse-support?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+socialservicesnews+%28Social+Services+News+from+IRISS%29
McShane's article is also worth a read as it is thought provoking. You can find it at http://www.guardian.co.uk/lifeandstyle/2010/nov/07/families-divided-by-the-state?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+socialservicesnews+%28Social+Services+News+from+IRISS%29
You can find Project Prevention at http://www.projectprevention.org/
Saturday, October 23, 2010
Australia - a horror story
In what can only be described as a horror story, a northern territory in Australia has admitted virtual failure of its child protection system, particularly with the indigenous people. The stories are horrific examples of a child protection system that has utterly failed to do the very thing it must - protect children. The Minister responsible has acknowledged how bad it is and the need for a complete restructuring of the system.
What is perhaps true but also frightening is the fact more children will suffer while they try to put together something that might work. The government deserves praise for seeing the necessity of change but one has to wonder how this could go on for as long as the news reports suggest.
We must learn here about the value of constant monitoring. Transparency should be an essential part of this monitoring. The UK system of serious case reviews is not perfect but there is at least some reporting to the public when something goes wrong. All jurisdictions should be willing to do that at least. Britain has shown how it can be done while still ensuring confidentiality as needed.
The Australian story can be found at
http://www.smh.com.au/national/we-failed-them--territory-to-overhaul-child-welfare-20101021-16w56.html
The official report identifies some themes that those of us in Canada will recognize such as the failure to allow Aboriginal groups a valid say in the protection of their children. Under resourcing is another very familiar theme. So is fragmented services, an unstable workforce with high demands matched with high turnover, lack of needed services and failures to monitor children.
This report echoes themes that we have been seeing in reports from New Zealand, Canada, the UK and elsewhere. If the themes are common, perhaps the problems are about the ways in which we have been building, funding and servicing child protection. Has the time come for a large scale debate?
Here is the official news release:
"19 October 2010A focus on prevention, collaboration, greater Aboriginal involvement and control of service delivery, and strengthening families and systems are at the heart of recommendations by the Inquiry into the Child Protection System in the Northern Territory.
In addressing what it described as the ‘overwhelming failure’ of the Northern Territory’s child protection system, the Inquiry’s three co‐chairs said it was important to focus on systemic failures not the many hard‐working, thoughtful, dedicated people struggling to cope with limited resources in an environment characterised by extreme need.
They said their inquiry had uncovered a “tsunami of need” that could be addressed only by immediate action to deal with an overburdened system, preventative measures to deal with the problems upstream and a dual response system to helping vulnerable families that doesn’t depend only on statutory interventions.
The inquiry’s report, “Growing them strong, together”, found the Northern Territory child protection system is in crisis because of:
• insufficient resources to deal with both the number of statutory interventions needed and the many issues beyond child protection that are integral to effective case management;
• the number of notifications of children formally identified as at risk which remain uninvestigated – currently there are nearly 1000 children in the Northern Territory identified as at risk who are receiving no support or investigation, with many more cases likely to be unreported;
• the fact that mandatory reporting was introduced without a commensurate increase in support services, with a tripling of notifications since 2003‐04 and a 79.4 per cent increase in the past two years;
• an almost complete lack of Aboriginal controlled services, despite the fact that 73 per cent of notifications relate to Aboriginal children;
• under‐resourced out of home care options (such as foster care and residential care) despite the fact that the $34 million budget is the most costly component of the Health and Families budget. The number of children in out of home care has more than tripled to 555 in the past 10 years, with Aboriginal children four times as likely as non‐Aboriginal children to be in care;
• a failure to monitor children in out of home care or provide appropriate support to foster parents, many of whom feel they are not respected, that they are subject to arbitrary decisions, and that children are moved in and out of their care with little planning or consultation;
• a non‐government sector that is poorly resourced yet could play a critical role in supporting families and children;
• fragmented service delivery across agencies, many of which lack confidence in the ability of the child protection system to respond to notifications of children at risk and to work collaboratively with them in addressing problems;
• overwhelming workforce issues, such as problems recruiting staff, high turnover, untenable caseloads, low morale, a lack of Aboriginal workers, ad hoc training and staff inductions and poor supervision;
• a lack of support and therapeutic services for protected young people in the Northern Territory, who are at risk of adverse mental health outcomes, relationship difficulties and becoming clients of the youth and adult justice systems.
The Board of Inquiry into the Child Protection System in the Northern Territory was appointed by the Chief Minister Paul Henderson in December 2009. Its three co‐chairs are Professor Muriel Bamblett, Dr Howard Bath and Dr Rob Roseb"
Source: http://www.apo.org.au/research/growing-them-strong-together-promoting-safety-and-wellbeing-northern-territory%E2%80%99s-children-r
It is noteworthy that the inquiry itself sums up what we have been seeing elsewhere with this statement from its introduction:
"The foremost finding of the Inquiry is that there needs to be organisational reform in child protection in the Northern Territory which includes a re-orientation towards a more collaborative approach to the task, as well as an immediate investment in more staffing resources for statutory child protection and out of home care (OOHC) services. This said, unless there is a robust concomitant commitment to developing culturally appropriate, early intervention and preventive services, the statutory service will never be able to keep up with demand. If change is to occur, we need to invest as much, if not more, into preventing the need for vulnerable children to be placed into care as we do to investigating and monitoring families and placing their children elsewhere" (p.2)
Like many jurisdictions, the question of demand for service outstripping supply should also tell us that there are serious problems in our society's framework when we simply can't fund enough child protection for the children who need protecting. Even if we narrow the definition of the kinds of family environments that require intervention, we are still unlikely to keep up with the demand.
The Australia report adds to the conversation about what is needed by outlining a series of principles - worthy ones indeed - but can we fund them as a larger society?
Services must:
Recognise 1. the principles central to the United Nations Convention on the
Rights of the Child (UNCROC) including:
• Children’s right to safety (including cultural safety), security and
wellbeing
• Families are best placed to care for children
• Government’s obligation is to provide the widest possible assistance to
support families in their child rearing role
• Children’s right to be free from abuse and neglect and that where
parents can’t or won’t protect and care for children (even with widest
possible assistance) the State needs to intervene and care for the child.
Statutory child protection is one part of a broad and robust system for
protecting children and ensuring their wellbeing.
2. Acknowledge the particular United Nations considerations that are
particularly relevant for Aboriginal children:3
• the interconnectedness between children, communities, culture and
context
• their present situation cannot be understood without reference to the
historical context and a large history of rights violations
• obstacles to the rights of Aboriginal self-determination remain a real
barrier to the realisation of the safety and wellbeing of children
• the significance of land and its loss and violation to Aboriginal people is
in part about its centrality in the future lives of the children.
3. Be child-centred in the context of family and community — protection of
children must occur within a framework of valuing children
4. Be based on the understanding that child protection is everyone’s
responsibility – whole of government and whole of community
5. Recognise the need to build capacity in families and communities which
requires family sensitive, culturally competent resources and systems for
families that they and their communities can influence and grow
6. Be culturally literate and competent enabling access and availability to all
cultural groups and able to acknowledge cultural differences and meet
unique cultural needs
7. Use local, place-based approaches and models as opposed to importing
ideas without adapting them to Northern Territory and local ways. Service
models need to be tailored to the local context – recognising that a system
for protecting children in remote communities, town camps, regional
communities and urban centres will be different
8. Be non-stigmatising and equitable and fair appreciating that all children
have the same rights to safety, security and wellbeing
9. Acknowledge that whilst procedures are important, the work involved in
caring for children, families and communities and keeping children safe is
deeply relationship-based
10. Establish a clear mission, philosophy and objectives; have a practice informed
management that can engage with front-line staff; and resource
and support a workforce that is enabled to do its work and have measurable
performance criteria
11. Use evidence-informed approaches and where this is not possible, at least
use theoretically informed approaches with a commitment to immediate
evaluation
12. Be accountable to specific performance standards that demonstrate defined
outcomes for children, families and communities.
What is perhaps true but also frightening is the fact more children will suffer while they try to put together something that might work. The government deserves praise for seeing the necessity of change but one has to wonder how this could go on for as long as the news reports suggest.
We must learn here about the value of constant monitoring. Transparency should be an essential part of this monitoring. The UK system of serious case reviews is not perfect but there is at least some reporting to the public when something goes wrong. All jurisdictions should be willing to do that at least. Britain has shown how it can be done while still ensuring confidentiality as needed.
The Australian story can be found at
http://www.smh.com.au/national/we-failed-them--territory-to-overhaul-child-welfare-20101021-16w56.html
The official report identifies some themes that those of us in Canada will recognize such as the failure to allow Aboriginal groups a valid say in the protection of their children. Under resourcing is another very familiar theme. So is fragmented services, an unstable workforce with high demands matched with high turnover, lack of needed services and failures to monitor children.
This report echoes themes that we have been seeing in reports from New Zealand, Canada, the UK and elsewhere. If the themes are common, perhaps the problems are about the ways in which we have been building, funding and servicing child protection. Has the time come for a large scale debate?
Here is the official news release:
"19 October 2010A focus on prevention, collaboration, greater Aboriginal involvement and control of service delivery, and strengthening families and systems are at the heart of recommendations by the Inquiry into the Child Protection System in the Northern Territory.
In addressing what it described as the ‘overwhelming failure’ of the Northern Territory’s child protection system, the Inquiry’s three co‐chairs said it was important to focus on systemic failures not the many hard‐working, thoughtful, dedicated people struggling to cope with limited resources in an environment characterised by extreme need.
They said their inquiry had uncovered a “tsunami of need” that could be addressed only by immediate action to deal with an overburdened system, preventative measures to deal with the problems upstream and a dual response system to helping vulnerable families that doesn’t depend only on statutory interventions.
The inquiry’s report, “Growing them strong, together”, found the Northern Territory child protection system is in crisis because of:
• insufficient resources to deal with both the number of statutory interventions needed and the many issues beyond child protection that are integral to effective case management;
• the number of notifications of children formally identified as at risk which remain uninvestigated – currently there are nearly 1000 children in the Northern Territory identified as at risk who are receiving no support or investigation, with many more cases likely to be unreported;
• the fact that mandatory reporting was introduced without a commensurate increase in support services, with a tripling of notifications since 2003‐04 and a 79.4 per cent increase in the past two years;
• an almost complete lack of Aboriginal controlled services, despite the fact that 73 per cent of notifications relate to Aboriginal children;
• under‐resourced out of home care options (such as foster care and residential care) despite the fact that the $34 million budget is the most costly component of the Health and Families budget. The number of children in out of home care has more than tripled to 555 in the past 10 years, with Aboriginal children four times as likely as non‐Aboriginal children to be in care;
• a failure to monitor children in out of home care or provide appropriate support to foster parents, many of whom feel they are not respected, that they are subject to arbitrary decisions, and that children are moved in and out of their care with little planning or consultation;
• a non‐government sector that is poorly resourced yet could play a critical role in supporting families and children;
• fragmented service delivery across agencies, many of which lack confidence in the ability of the child protection system to respond to notifications of children at risk and to work collaboratively with them in addressing problems;
• overwhelming workforce issues, such as problems recruiting staff, high turnover, untenable caseloads, low morale, a lack of Aboriginal workers, ad hoc training and staff inductions and poor supervision;
• a lack of support and therapeutic services for protected young people in the Northern Territory, who are at risk of adverse mental health outcomes, relationship difficulties and becoming clients of the youth and adult justice systems.
The Board of Inquiry into the Child Protection System in the Northern Territory was appointed by the Chief Minister Paul Henderson in December 2009. Its three co‐chairs are Professor Muriel Bamblett, Dr Howard Bath and Dr Rob Roseb"
Source: http://www.apo.org.au/research/growing-them-strong-together-promoting-safety-and-wellbeing-northern-territory%E2%80%99s-children-r
It is noteworthy that the inquiry itself sums up what we have been seeing elsewhere with this statement from its introduction:
"The foremost finding of the Inquiry is that there needs to be organisational reform in child protection in the Northern Territory which includes a re-orientation towards a more collaborative approach to the task, as well as an immediate investment in more staffing resources for statutory child protection and out of home care (OOHC) services. This said, unless there is a robust concomitant commitment to developing culturally appropriate, early intervention and preventive services, the statutory service will never be able to keep up with demand. If change is to occur, we need to invest as much, if not more, into preventing the need for vulnerable children to be placed into care as we do to investigating and monitoring families and placing their children elsewhere" (p.2)
Like many jurisdictions, the question of demand for service outstripping supply should also tell us that there are serious problems in our society's framework when we simply can't fund enough child protection for the children who need protecting. Even if we narrow the definition of the kinds of family environments that require intervention, we are still unlikely to keep up with the demand.
The Australia report adds to the conversation about what is needed by outlining a series of principles - worthy ones indeed - but can we fund them as a larger society?
Services must:
Recognise 1. the principles central to the United Nations Convention on the
Rights of the Child (UNCROC) including:
• Children’s right to safety (including cultural safety), security and
wellbeing
• Families are best placed to care for children
• Government’s obligation is to provide the widest possible assistance to
support families in their child rearing role
• Children’s right to be free from abuse and neglect and that where
parents can’t or won’t protect and care for children (even with widest
possible assistance) the State needs to intervene and care for the child.
Statutory child protection is one part of a broad and robust system for
protecting children and ensuring their wellbeing.
2. Acknowledge the particular United Nations considerations that are
particularly relevant for Aboriginal children:3
• the interconnectedness between children, communities, culture and
context
• their present situation cannot be understood without reference to the
historical context and a large history of rights violations
• obstacles to the rights of Aboriginal self-determination remain a real
barrier to the realisation of the safety and wellbeing of children
• the significance of land and its loss and violation to Aboriginal people is
in part about its centrality in the future lives of the children.
3. Be child-centred in the context of family and community — protection of
children must occur within a framework of valuing children
4. Be based on the understanding that child protection is everyone’s
responsibility – whole of government and whole of community
5. Recognise the need to build capacity in families and communities which
requires family sensitive, culturally competent resources and systems for
families that they and their communities can influence and grow
6. Be culturally literate and competent enabling access and availability to all
cultural groups and able to acknowledge cultural differences and meet
unique cultural needs
7. Use local, place-based approaches and models as opposed to importing
ideas without adapting them to Northern Territory and local ways. Service
models need to be tailored to the local context – recognising that a system
for protecting children in remote communities, town camps, regional
communities and urban centres will be different
8. Be non-stigmatising and equitable and fair appreciating that all children
have the same rights to safety, security and wellbeing
9. Acknowledge that whilst procedures are important, the work involved in
caring for children, families and communities and keeping children safe is
deeply relationship-based
10. Establish a clear mission, philosophy and objectives; have a practice informed
management that can engage with front-line staff; and resource
and support a workforce that is enabled to do its work and have measurable
performance criteria
11. Use evidence-informed approaches and where this is not possible, at least
use theoretically informed approaches with a commitment to immediate
evaluation
12. Be accountable to specific performance standards that demonstrate defined
outcomes for children, families and communities.
Sunday, October 17, 2010
Intuition and child protection
Duncan Helm, a British researcher, has just published Making Sense of Child and Family Assessment. While I have yet to receive a copy (it is on the way) I am intrigued by an approach that he has taken in his work - that intuition does and must play a role in child protection decision making.
Such an idea runs counter to what has become the risk aversive atmosphere of child protection throughout the west. This has led to the introduction of more and more risk assessment tools which are not faring well under the scrutiny of researchers. Largely speaking, they are not yielding results that support them as being effective.
Social work is a human endeavor and, as such, requires human judgment. That requires assembling available data and making decisions. Intuition is part of that process but, as Professor Helm notes, not a valued or well researched part of it.
In an interview with the Herald Scotland, he stated, "Mr Helm argues that many social work leaders fear and try to prevent workers acting on intuition. After a series of high-profile failures in child protection, inquiries into cases which have gone wrong have compounded the problem....The human element at the core of good judgment seems to be getting written out.”
The article goes on to state, "When you have a gut feeling where do you go with that? “Workers say when they come to case notes and records there is no place to record gut feeling. But that sense that ‘I don’t know what this is but I know I’ve seen it before’, can be valuable.”
We need to enhance these skills so that experience can be used along side various other tools that enhance decision making. Denying the intuitive portion of decision making is to deny reality. Bravo to Prof. Helm for raising this.
Such an idea runs counter to what has become the risk aversive atmosphere of child protection throughout the west. This has led to the introduction of more and more risk assessment tools which are not faring well under the scrutiny of researchers. Largely speaking, they are not yielding results that support them as being effective.
Social work is a human endeavor and, as such, requires human judgment. That requires assembling available data and making decisions. Intuition is part of that process but, as Professor Helm notes, not a valued or well researched part of it.
In an interview with the Herald Scotland, he stated, "Mr Helm argues that many social work leaders fear and try to prevent workers acting on intuition. After a series of high-profile failures in child protection, inquiries into cases which have gone wrong have compounded the problem....The human element at the core of good judgment seems to be getting written out.”
The article goes on to state, "When you have a gut feeling where do you go with that? “Workers say when they come to case notes and records there is no place to record gut feeling. But that sense that ‘I don’t know what this is but I know I’ve seen it before’, can be valuable.”
We need to enhance these skills so that experience can be used along side various other tools that enhance decision making. Denying the intuitive portion of decision making is to deny reality. Bravo to Prof. Helm for raising this.
Monday, October 11, 2010
Is child protection failing?
In a 2006 study Naristela Zell looked at child welfare workers and their views on the system. The research took place in New York and Chicago but anyone who has worked in the child welfare systems of the western world will find her results all too familiar.
"The major themes that emerged from the analysis indicate caseworkers believed that the child welfare system does not meet the needs of the children in care, lacks the resources to appropriately serve clients, and often establishes goals that cannot be attained by the biological parents. Caseworkers held negative views of the biological parents and, although most described their organization as well equipped, almost as many reported that their organization lacked technical, administrative, and personnel resources. Caseworkers' views of child welfare policies emphasized the need for reforming the system and reevaluating funding priorities" (abstract, p.83).
These are the views of people actually working in the system on a day to day basis. They help us to see that services are under resourced and the system is not creating the kinds of changes needed.
In 2010, Kristien Campbell and her colleagues have published a study of enormous value that helps us to see that the views of child protection workers are not disgruntled voices from over worked child protection workers. While Campbell et al.'s work has been celebrated by critics of child protection systems as being self evident and obvious to anyone who has bothered to look or listen to parents, the research adds dimensions to the public policy debate and practice standards needed to serve families.
Here are the highlights of their conclusions:
"Are modifiable risks associated with CPS investigation?
CPS investigation between ages 4 and 8 years was associated with
increased maternal depressive symptoms at age 8 years (P<.05)
(see next slide for comparison with other available measures).
Does CPS substantiation of maltreatment alter these findings?
CPS substantiation of maltreatment did not alter primary results.
Are modifiable risks reduced with time since CPS investigation?
Increased time from CPS investigation was associated with increasing household, caregiver, and child risk."
"We found an association between CPS investigation and subsequent increased depressive symptoms in maternal caregivers.
We found no association between CPS investigation and subsequent social support, family function, poverty, maternal education, and child behavior problems.
Our results suggest that a CPS investigation represents a missed opportunity to reduce risks in these high-risk households." (Source archpediatrics.com).
What this work helps to identify are very key public policy issues that are desperately in need of debate. The main, although not all of the issues are:
1. Child protection has become the sole purview of social work. (see also part 1 of the Munro report in the UK). This is wrong. As Bergman (2010) in an allied editorial with the Campbell research has noted, general practitioners and public health nurses will spend much more time with a family than will a child protection worker. We need get them fully integrated into protecting children through their powerful and trusted roles. CPS is better at working with families that are intransigent or distant from community based services such as doctors and nurses.
2. We need to be using proven and effective interventions as opposed to those that we have always used or are just available even though there is little evidence to show effectiveness. Dr. H. McMillan from McMaster University in Hamilton, Ontario noted in a presentation in 2009 that most current parent interventions are not achieving long term changes. This is part of the reason why so many child protection cases re-open.
3. We must accept that a large portion of child protection matters exist not because of failings of parents but failings of society that have yet to address poverty and other forms of oppression that are so closely ties to most child protection cases. Too often we blame the victim of the system as opposed to the society that created the problem.
4. We must be prepared to fund the kinds of interventions that do make a difference. CPS systems have been under such budget restraint that they no longer try for long term but focus on what is needed to address the current crisis only. Is it no wonder that so many cases re-open.
5. Child death cases (which too often create knee jerk reactions leading to poor case management, system protection and over apprehension of children) should have shown us that the current systems are not working.
6. When courts are involved, we set up an adversarial system between child protection and the family. The child is lost in the mix as the parents become the focus and not the child.
This is a topic that should not go away and requires much more debate.
References:
Bergman, A.B. (2010).Child protective services has outlived its usefulness. Archives of Pediatric and Adolescent Medicine, 164 (10), 978-9.
Campbell, K.A., Cook, L.J., LaFleur, B.J. & Keenan, H.T. (2010). Household, family and child risk factors after an investigation for suspected child maltreatment. Archives of Pediatric and Adolescent Medicine, 164 (10),943-9.
Zell, M. (2006). Child welfare workers: Who they are and how the view the system. Child Welfare, 85 (1), 83-108.
"The major themes that emerged from the analysis indicate caseworkers believed that the child welfare system does not meet the needs of the children in care, lacks the resources to appropriately serve clients, and often establishes goals that cannot be attained by the biological parents. Caseworkers held negative views of the biological parents and, although most described their organization as well equipped, almost as many reported that their organization lacked technical, administrative, and personnel resources. Caseworkers' views of child welfare policies emphasized the need for reforming the system and reevaluating funding priorities" (abstract, p.83).
These are the views of people actually working in the system on a day to day basis. They help us to see that services are under resourced and the system is not creating the kinds of changes needed.
In 2010, Kristien Campbell and her colleagues have published a study of enormous value that helps us to see that the views of child protection workers are not disgruntled voices from over worked child protection workers. While Campbell et al.'s work has been celebrated by critics of child protection systems as being self evident and obvious to anyone who has bothered to look or listen to parents, the research adds dimensions to the public policy debate and practice standards needed to serve families.
Here are the highlights of their conclusions:
"Are modifiable risks associated with CPS investigation?
CPS investigation between ages 4 and 8 years was associated with
increased maternal depressive symptoms at age 8 years (P<.05)
(see next slide for comparison with other available measures).
Does CPS substantiation of maltreatment alter these findings?
CPS substantiation of maltreatment did not alter primary results.
Are modifiable risks reduced with time since CPS investigation?
Increased time from CPS investigation was associated with increasing household, caregiver, and child risk."
"We found an association between CPS investigation and subsequent increased depressive symptoms in maternal caregivers.
We found no association between CPS investigation and subsequent social support, family function, poverty, maternal education, and child behavior problems.
Our results suggest that a CPS investigation represents a missed opportunity to reduce risks in these high-risk households." (Source archpediatrics.com).
What this work helps to identify are very key public policy issues that are desperately in need of debate. The main, although not all of the issues are:
1. Child protection has become the sole purview of social work. (see also part 1 of the Munro report in the UK). This is wrong. As Bergman (2010) in an allied editorial with the Campbell research has noted, general practitioners and public health nurses will spend much more time with a family than will a child protection worker. We need get them fully integrated into protecting children through their powerful and trusted roles. CPS is better at working with families that are intransigent or distant from community based services such as doctors and nurses.
2. We need to be using proven and effective interventions as opposed to those that we have always used or are just available even though there is little evidence to show effectiveness. Dr. H. McMillan from McMaster University in Hamilton, Ontario noted in a presentation in 2009 that most current parent interventions are not achieving long term changes. This is part of the reason why so many child protection cases re-open.
3. We must accept that a large portion of child protection matters exist not because of failings of parents but failings of society that have yet to address poverty and other forms of oppression that are so closely ties to most child protection cases. Too often we blame the victim of the system as opposed to the society that created the problem.
4. We must be prepared to fund the kinds of interventions that do make a difference. CPS systems have been under such budget restraint that they no longer try for long term but focus on what is needed to address the current crisis only. Is it no wonder that so many cases re-open.
5. Child death cases (which too often create knee jerk reactions leading to poor case management, system protection and over apprehension of children) should have shown us that the current systems are not working.
6. When courts are involved, we set up an adversarial system between child protection and the family. The child is lost in the mix as the parents become the focus and not the child.
This is a topic that should not go away and requires much more debate.
References:
Bergman, A.B. (2010).Child protective services has outlived its usefulness. Archives of Pediatric and Adolescent Medicine, 164 (10), 978-9.
Campbell, K.A., Cook, L.J., LaFleur, B.J. & Keenan, H.T. (2010). Household, family and child risk factors after an investigation for suspected child maltreatment. Archives of Pediatric and Adolescent Medicine, 164 (10),943-9.
Zell, M. (2006). Child welfare workers: Who they are and how the view the system. Child Welfare, 85 (1), 83-108.
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