Family support better than crisis-driven policy

We are becoming all too familiar with young people having their right to residential care vindicated by determined judges. Recently, for example, distraught parents appealed to Mr Justice Kelly basically to arrest their 13-year-old son because he was out of home, out of control and, according to his mother, drifting into his own underworld.

In the past Mr Justice Kelly and other judges have been willing to rap everyone from government ministers to health boards over the knuckles to force them to provide care, usually high-support care.

Given the scarcity of such places, the following fictitious scenario may sound absurd. Imagine a teenager who has been placed in such a unit. What if she took a health board to court because of their abject failure in allowing her to get to a stage where this was the only alternative?

She could claim that the social services had been aware of her family difficulties from an early age, yet no appropriate action had been taken until the only option was high-support care.

Another example of litigiousness gone crazy? Or a logical outcome if the emphasis in our services was at least as much on family support as on child protection? Judges do us a service by demanding help for children who have reached the end of the road. But the sad reality is that the outcome of such care is pretty dismal. Some 40 per cent of our homeless people have been in care.

The Focus Ireland study, Out On Their Own, has an even grimmer statistic. Within six months of leaving special schools 51 per cent of young people are in or have been in detention.

What we have at the moment is still a system which is largely crisis-driven rather than preventive. Often there is still a depressing lack of co-ordination between key Government Departments such as Education, Justice and Health, mirrored in a similar lack of co-ordination between services on the ground. As a result, children are damaged who could have been helped at an earlier stage.

When child protection is the primary focus, the emphasis is on intervention when a child is being, or is in danger of being, harmed. No one denies that this is vital work, and the tragedy is that it is often carried out in such a piecemeal fashion with little co-ordination between State agencies.

However, family support when properly resourced and staffed can help to prevent child-protection issues arising. It is based on the premise that when people have problems their first thought is not of social workers. Instead, we think of family, friends or neighbours.

People in adversity may not be able to mobilise such support networks. Take a mother with alcohol problems whose children are running wild and living off McDonald's takeaways. The mother may be isolated from relatives or community members who are a potential source of support for the children. This is where professionals can help, not as omnipotent advice-givers, but helping to access what is already there.

A central concept of family support services is the belief that families, no matter how formidable or seemingly intractable their problems, also contain strengths and assets that if supported and channelled can produce solutions.

Although family support is far from central in our social services, things are changing slowly. The National Children's Strategy emphasises prevention and family support. The National Children's Office is a positive move, as is the National Inspectorate for Social Services.

ANOTHER sign of hope is the success of what are called Springboard projects. Springboard is specifically focused on supporting families with children in a community context before situations deteriorate into a crisis. Relevant State agencies are involved, but so are the voluntary sector and, most importantly, family networks and the local community.

This kind of approach is particularly important when dealing with young people at risk. Writing in Family Support - Direction from Diversity, Pat Dolan and John Canavan say: "Working with a young person successfully inevitably means working with the family, particularly parents . . . Effective community-based interventions may only be optimally successful where parents are engaged as key players."

Pat Dolan, representing the Western Health Board, and John Canavan, representing NUI Galway, organised an international conference on family support in 1998. A further such conference, "International Family Support Evaluation", is scheduled for June 7th8th in Galway. This is an important initiative, because any intervention needs a solid underpinning of research.

Dolan is regional co-ordinator of family support services in the Western Health Board area. What does it say about priorities that there is no equivalent post in other health-board areas? There are moves to appoint family support co-ordinators at county level, but it is still sporadic.

When researching what parents need from family support, Dolan discovered that it was not so much emotional support that parents appreciated, but practical support. Taking adolescents away for, say, a canoeing weekend gave parents a break from a stressful situation. This is not to suggest that social workers be treated as baby-sitters, but such imaginative initiatives are needed.

Also writing in Family Support, Robbie Gilligan, of the Social Studies Department in Trinity College Dublin, uses the metaphor of a fire brigade and a milk van. The fire brigade approach is sudden, once-off and crisis-driven. The milk van is low-key, regular and reliable. It is obvious which is preferable. Of course, no one would claim that the milk van approach will solve all ills, but it has a far greater chance of heading off crises.

Taking a child away from the family is one of the most traumatic things that can happen to him or her, even when home is chaotic. Of course, no child's safety should ever be compromised, which is why a high degree of accountability is vital.

But residential care should always be seen as a failure of the system. Aside from anything else, it can cost anything from £40,000 to £100,000 depending on the degree of support needed. In contrast, family support costs about £2,500 a year. Our fictitious teenager suing a health board would simply be asking: why so much now, and so little earlier?

bobrien@irish-times.ie

The International Family Support Evaluation conference is in Galway on June 7th and 8th. Tel: 091-775315