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“How safe are our children?”

The NSPCC report on child abuse and neglect.

 The report can be found here

http://www.nspcc.org.uk/Inform/research/findings/howsafe/how-safe-2013-report_wdf95435.pdf

 and is interesting and well worth a read. It is quite stat heavy, but there are decent graphs which make the points well, and they set out how the stats were arrived at. (One of their core ones, I have an issue with, but will deal with that a bit later on)

The latter bits of the report set out the risk indicators for children, nearly all of which are not likely to come to a shock to anyone working within the family justice system.

You are more likely, as a child, to be physically abused or neglected if these factors are present in your family :-

Domestic violence, substance misuse, parents with mental health problems, parents with learning difficulties, children with physical or mental impairments, children from certain ethnic or minority backgrounds,  parents who suffered abuse themselves as a child, and poverty.

 The poverty one is interesting, because it is the elephant in the room at the moment. Is part of our child protection system, as might be argued by John Hemming and perhaps Dr Dale, a punitive way of dealing with the poorest members of our society (and perhaps even a redistribution of children from those who have them, to those with greater means and income who would adopt them?)

 Also of course, from everything we know about the political climate of the country at present, poverty is only going to get worse over the next few years (unless you were on the Board of HBOS or are a stockholder in Vodafone, Starbucks, Google et al)

 Here’s what the report says about poverty as a risk factor [underlining is mine, as I think this is a VITAL point]

 Children living with poverty, debt and financial pressures

Why is this a risk factor?

Although there is no evidence to show that poverty causes child maltreatment, poverty and child maltreatment share many similar risk factors. Numerous explanations try to explain the relationship between poverty and child abuse and neglect. The impact of the stress associated with poverty and social deprivation on parenting is the most common explanation.

Researchers have found that parents with a low income are four times more likely to feel chronically stressed than parents with higher incomes. Stress levels of parents living in poorer neighbourhoods have been shown to be high. One study identified a “strong relationship between parents’ levels of stress and greater use of physical discipline”. Another associated being in a lower socio-economic group with a more significant level of physical discipline and abuse.

An analysis of women’s childhood experiences of abuse and neglect found evidence that women from poorer childhood homes were twice as likely to have suffered from abuse or neglect and three times as likely to have suffered from more than one form of abuse than those from more well-off childhood homes. Emerging findings from research in England highlight the impact of poor and inadequate housing on families and poor housing is a common characteristic of families in poverty. The unsafe environment and the impact of parental stress have been found to be factors in some SCRs and where children are subject to child protection plans.

 

This does not mean that parents who are poor will abuse or neglect their children. The relationship has been described as “circular and interdependent as opposed to linear and causal”.

 

What we know about prevalence

The Institute for Fiscal Studies estimates that the number of children living in relative poverty in the UK85 was around 2.5 million in 2012, rising to about 2.9 million in 2015.86

 

 Being poor doesn’t mean that you will neglect your children, but being poor of course means that you are much more likely to have to make difficult choices about budgeting and poor choices have a much more detrimental effect.  (If you are choosing between whether to spend £80 or £110 one week on food shopping for the next week, choosing the latter one week doesn’t massively affect your family, but if you are choosing between whether to spend £15 or £25 on shopping that week, and perhaps to spend the extra £10 means not having the heating on, those choices do make a proportionately greater difference to the wellbeing of the family.

 There is an interesting tack in the main body of the report. The NSPCC calculate that for every child known to the authorities to be suffering from abuse or neglect, there are another 8 who are not known.   [This is the statistic I am most cautious about, since it is drawn from an extrapolation of their 2011 study that showed children self-reported abuse or neglect  (6% of over 11s, and 2.5% of under 11s) and applied that to the population at large. For me, I would need the 2011 study to be much larger and more robust before you could start extrapolating it to the population at large – for example, if you are asking a 14 year old whether they have been seriously mistreated by their parents in the last year, that 14 year old’s idea of serious mistreatment might be very different to society’s idea of it. There might well be days when almost any 14 year old would say that his parents were mistreating him]

 But, setting aside my quibble about the number of children who are the bottom part of that iceberg, under the surface and unknown to professionals, the NSPCC say this

 The gap is unlikely to close

Could services ever reach all maltreated children? Even if this were desirable (and few would consider this level of state intrusion into family life appropriate) it is very unlikely in the current context. If children’s social services were to become aware of just one quarter of those children who were maltreated (but not currently known to them), we estimate the number of children subject to child protection plans or on registers in the UK would triple. The resources required for this would be significant: an estimated additional £360 million to £490 million in public spending. In today’s fiscal climate this kind of investment is unlikely; to close the gap altogether is highly improbable. Nor is this the most effective approach. While it is vital to support children and adults in speaking up about abuse, in order to stop abuse in its tracks, this will never be enough to prevent children from being harmed in the first place.

 

 

This seems to be a bold, if pragmatic, thing to say about child abuse. Particularly for an organisation has been campaigning for the last few years on the basis of ending child abuse.  Cruelty to children must end, FULL STOP (remember?)

They are now accepting that society simply can’t end it or stop it. There will always be child abuse and neglect.  And as they point out, even if you raised detection levels to a much higher point, that would have a huge and detrimental impact on freedom and privacy and family life, and the resourcing of the services would be utterly unmanageable for our society to fund.

 So, are the NSPCC throwing in the towel?  Unsurprisingly, not. What they instead posit is moving towards the very early period of child abuse and neglect and nipping that in the bud before it escalates into more serious problems.

 We need a different approach to child protection

 

Which is why a different approach to child protection is needed, one that does more to prevent abuse “upstream” rather than intervening to stop it once it has already happened. Most public spending goes towards picking up the pieces rather than into “upstream” prevention. The National Audit Office estimates that only 6 per cent of public expenditure is focused on stopping problems from emerging in the first place.

 

While intervening to address abuse once it is known will always be a moral and legal imperative, child abuse and neglect will never be substantially reduced unless we become smarter at preventing it from happening at all.

 

Understanding the circumstances in which children are at increased risk is essential for prevention. Research points to the personal characteristics, family circumstances and environments that place children at greater risk of abuse and neglect. In Part 3, we set out the available evidence on this, highlighting nine key risk factors. There is no direct causality between these factors and abuse; they are not predictive of maltreatment. But by recognising that children living in such circumstances are at heightened risk, greater support could be directed towards families to reduce the chances of abuse and neglect from occurring at all. While this support comes at a price, it is ultimately more cost-effective to prevent abuse from occurring than to meet the many costs that fall across society because of the damage caused to children who were abused or neglected in their childhood.

 

Wider society also has an important role to play. Abusive behaviour cannot be stamped out by the state alone; individuals, families and communities must also be responsible for the change. Most adults think parents, families, friends and neighbours have a responsibility to prevent child abuse – and that greater responsibility lies with these groups than with government.

 

So while government can do much to influence the conditions in which children live and while professionals play an important role in intervening to protect children and helping those who are at risk of abuse, wider society has a responsibility too. However, all too often people frame this responsibility in terms of being willing to act if worried about a child, rather than being willing to address faults in their own or others’ behaviour. Perhaps it is time to reassert our responsibilities to children as citizens.

 

 

I can’t say I’m sure how the NSPCC vision here gets translated into action, but I think it is a legitimate and interesting debate to have as a society.  I thought the report as a whole (although I don’t agree with every aspect) was a challenging and thought-provoking document.

 There are some very mind-boggling figures in it

 There were a total of 21,493 sexual offences against children recorded by police in the UK in 2011/12.*

 There were 4,991 rapes of children recorded by police in England and Wales in 2011/12.

 There were 7,812 cruelty and neglect offences recorded by police in the UK in 2011/12.

“Returning home from care” – an analysis of the NSPCC research on rehabilitation of looked after children

The NSPCC have published their research into outcomes for looked after children who are rehabilitated to the care of their parents. The report can be found here: –

http://www.nspcc.org.uk/Inform/resourcesforprofessionals/lookedafterchildren/returning-home-from-care_wdf88986.pdf

Their big headline figure is that over 70% of the children in that situation they surveyed said that they weren’t ready to go home.

That initially made me blink, and wonder why the children had said that to the NSPCC but hadn’t said it to their Guardians, but then I realised that the pool of children concerned were probably the older children who were going home from s20 care rather than care proceedings.

There are still some startling figures in the report, however. In 2011, 90,000 children were looked after in England. 39% returned home (about 10,000 children, compared to the 3,050 who were adopted) Of the children who return home, between a third and a half come back into local authority care because the rehab breaks down, and around half suffer further abuse at home.

The NSPCC suggest that variance in Local Authority practice plays more of a part in whether a child is rehabilitated and whether that rehabilitation is successful than the child’s needs.

The report is quite critical of whether the family Courts have skewed the protection of children as against parental rights and article 6 too much in favour of parents.

“For children on care orders, family courts play a central role in assessing whether a child should return home. Their involvement can lead to improved planning and service provision26. However, courts have been shown to favour parents’ rights over those of the child27,28. Interviewees told the NSPCC that courts often instructed reunification, even when it was not in the best interests of the child, with decision making tipped in favour of the parents rather than the child.”

The tiny footnote there is referring to the Farmer research published in 2011, which is also worth a read.

The NSPCC recommendation in this regard is :-

Action must be taken to ensure that court decisions are always based on the child’s best interests. The new Family Justice Service must ensure that members of the judiciary specialising in family law receive training in child development and the implications of returning home from care. Information made available to the courts must enable members of the judiciary to receive better feedback on the outcome of their decisions.

To an extent, this strikes a chord with the Justice Ryder modernisation campaign, with its suggestion that the Family justice system should commission and take notice of some agreed research, rather than operating in a vacuum. I have to say, that for many years, my default reaction to seeing research quoted in a social work report is to reach for the red pen (or now, the ‘strikethrough’ button) as I know how unpopular it can be with the bench or judiciary to have a lot of research spouted to them -it tends to be either a statement of the bleeding obvious, in which case, why bother, or something which supports a proposition which is controversial (such as – the odds are that this child you’re thinking of sending home is 50-50 to suffer abuse at home as a result, or having five sessions of contact with a parent per week isn’t actually good for a baby) in which case nobody trusts it.

But you know, if all of the time and money we spend in trying to reach the right outcomes for children is resulting in half of the children we send home after that exhaustive process being abused, then we might want to recalibrate.

(of course, from the other side of the coin,  there’s something of a paucity of research as to the number of children who get long-term fostered or adopted when the Court and professionals were wrong and they could  successfully have gone home – that’s probably a harder piece of research to work out – probably working on the parents who go onto have another child and successfully care for that later child)

It is a bit hard to totally trust research commissioned by the NSPCC – I’m not questioning their integrity in the slightest, but when it comes down to working out where they stand on the “Keep children safe at all costs” versus “keep families together at all costs” spectrum (or the Cleveland-Haringey axis, if one is being unkind) it doesn’t take long to spot that they come with an agenda.

(Not necessarily a bad agenda – I wouldn’t claim to be precisely on the fulcrum of that particular see-saw myself – but it makes it harder to rely on their research as probative. It’s like seeing a report from Benson and Hedges about passive smoking – you sort of suspect there’s a starting point there)

 I liked this quote from a senior social work manager, though :- “Support is crucial. [But] we have to take a pragmatic approach as often the support that has been suggested by the courts or experts is simply not available.”

 Very true – an awful lot of expert reports which recommend that the door to rehab is not shut do so in complete absence of context about just how feasible it is that the parents GP will commission six months of therapy for them, and that that can start without delay.

The first bit of this next quote is blindingly obvious, the second part much less so.

Poor parenting, drug or alcohol misuse, domestic violence, and parental mental health problems, all increase the chance of harm when the child returns home. Farmer et al found that 78 per cent of substance-misusing parents abused or neglected their children after they returned from care, compared to 29 per cent of parents without substance misuse problems29

 

78% of rehabs involving substance-misusing parents result in further abuse or neglect. Being a maths guy, that suggests to me that rehab to parents who misuse substances is more likely than not to result in the child being abused or neglected if rehabilitated to their care. (of course, what you argue in any individual case is that for this particular parent, these are the factors that mean the Court can be confident that they are one of the 22% who won’t abuse their child; but that context of how prevalent the risks are to that subject-group remains important.)

 The challenge of rehab to a substance-misusing parent is significant – on the one hand, if you can resolve the drug problems there’s often a good parent underneath, but on the other it is so easy to be over-optimistic about an upward curve on a graph of peaks and troughs being a sign of a genuine change – being too close to the graph to see the pattern as being anything other than up, up and up)

From a bit more of a parental perspective, I think this is probably a valid and fair criticism of LA support.

Where support is provided it is often removed after a short period of time, before a problem has been sustainably addressed. Alongside resource constraints, support can be removed due to a belief that parents need to be able to shoulder their responsibilities and not become dependent on services33. Support is often discontinued once a child returns home without any assessment of whether the families’ problems have diminished. This results in further instability and an increased risk of harm to the child. Parents also report concerns about the short-term nature of interventions designed to support them.

Some more recommendations – all of which make sense to me

Decisions about whether a child should return home must always be led by what is in their best interests.   [Of course, it already is, it is just that what one body thinks is in the child’s best interests isn’t necessarily the same as what another body thinks]

Support for children and their families prior to and following reunification must improve. 

 The government should ensure there is sufficient support for parents who abuse drugs and alcohol, who are victims of domestic violence, who have mental health difficulties or who have other issues which could affect their ability to parent effectively when their child returns from care. Local services must be incentivised to provide sufficient support for these parents. 

 Local authorities must ensure that the support provided to children and families matches the needs identified in a child’s risk assessment. This information should be used to inform local commissioning and investment decisions. •

Local authorities must ensure that foster carers and residential care workers are involved in the process of a child returning home from care and are supported to help the child prepare for a return home, where that is in their best interests. 

 Guidance on designated teachers for looked after children should be revised to include children who return home from care, even if they cease to be looked after on their return. The support provided by the school can play an effective part in successful returns home.

The very last bit of the report sets out a new method of classifying risk, which the NSPCC are working with 8 local authorities on. To my cynical eye, it looks somewhat simplistic given how complex the variables are in child protection cases, but it’s not bad as a benchmarking exercise. I’m not sure I’d place quite as much weight on them as the child’s wish to return home being an element that allows you to consider the risk is lower. (It seems to be about a third of the factors in weighing the risk, which appears to my untrained eye to be far, far, far, far, too high)

Classifying the risk of reunification – a tool to support decision making about children returning home from care, adapted from Safeguarding Babies and Very Young Children from Abuse and Neglect (Ward, Brown and Westlake, 2012) 

 Severe risk

 • Risk factors apparent and not being addressed, no protective factors apparent.

 • No evidence of parental capacity to change and ambivalence or opposition to return home by child or parent.

High risk

 • Risk factors apparent, and not being addressed. At least one protective factor apparent.

• No or limited evidence of parental capacity to change and ambivalence or opposition to return home by child or parent.

Medium risk

• Risk factors apparent or not all risk factors addressed. At least one protective factor apparent.

 • Evidence of parental capacity to sustain change. Parents and child both want return home to take place. 

 Low risk

 • No risk factors apparent, or previous risk factors fully addressed, and protective factors apparent.

• Evidence of parental capacity to sustain change. Parents and child both want return home to take place.