Social workers are key in helping troubled families, writes Carl O'Brien, Social Affairs Correspondent
Even though she's been working as a child protection social worker for more than two years, Rachel McCormack is still staggered by the hidden scale of child neglect.
"People don't see it as being part of modern-day society but we're dealing with it on a daily basis," the 29-year-old Cork city-based social worker says. "It's behind closed doors, out of sight of most people."
It is a hidden world of families living on the edge of the society, on the edge of the health system and, sometimes, on the edge of life itself.
"With one family we came across, the children were living in a dark house, full of damp, with no central heating. The children didn't know what toilet roll was. They were scared of the shower or the bath. They didn't know about bed sheets or about light switches," she recalls.
"The effect on children can be dramatic. You have children, maybe five or six years of age, effectively parenting the younger children . . . Other children that present to us appear to have mild learning disabilities, but they're the result of a lack of stimulation . . . A lot of it is an inter-generational thing, where children just don't know any other way of life."
It seems incredible but, despite the affluence of modern society, child neglect remains the most common reason for children being taken into care. Some 60 per cent of the 2,300 children taken into care in 2005 was because they were neglected at home.
In many ways, social workers deal on a daily basis with the symptoms of society's failings, trying to help parents who fall through the cracks, linking them in with health or social supports, while ensuring children's needs are met.
Yet social workers say they are reaching a crossroads: many feel that a caring and compassionate service has become strangled by a legalistic and bureaucratic approach to work, against a backdrop of scarce resources, a shoddy health service and heavy caseloads.
The cost, they say, is a compromised service which is affecting the quality of support available to vulnerable children and families.
At the end of last month, professionals from across Ireland and the UK discussed the future of social work in Ireland at a conference organised jointly by University College Cork, the HSE South and the Irish Association of Social Workers.
They touched on topics such as: how to reconnect with the core values of social work; how to make the voice of social workers heard in public policy and in the media; and how to improve services and deal with the challenges of a rapidly changing society.
One of the conference organisers, Joe McCarthy, says a big problem for social work is that its success stories remain hidden. Media coverage tends to focus on the cases of children or families who appear to have been failed by the system. But it is the capacity to help bring about positive change in people's lives that keeps many social workers going.
"Social work can be very demanding and taxing at all levels, not least of all emotionally. The turnover rate among staff isn't difficult to understand. Those involved in [ child protection and family welfare] display huge resilience. Despite the many constraints they encounter, they successfully manage to deliver a service which, like the people with whom they work, remains hidden," he says.
"The very difficult challenges they encounter on a daily basis are equalled only by their commitment, dedication and belief that they can and do make a significant difference, particularly in the lives of children.
"Their presence does make a difference for the better and this is what sustains them."
Rachel McCormack is one of a group of child-protection workers based in the social work unit on the northside of Cork city.
The team responds to emergency cases where families or children require immediate support. Other social workers engage with families on a longer-term basis, supporting parents and children living in the most challenging of environments.
Only in the most extreme cases are children taken into care, usually with foster parents or relatives.
"Each case is different. It's impossible to say what exactly has gone wrong for a family, but often it's that parents themselves are victims. They may have been abused as children; they may have left school early and have poor literacy levels; or they may have addiction problems," says McCormack.
Keeping a family together in the community, with access to the supports they need, is a priority.
"There are family support projects working with parents, providing support like parenting skills, feeding and dressing the children, keeping appointments, that kind of thing.
"In a family you look for strengths, it might be their extended family or neighbours, and you take it from there," says McCormack.
Her biggest frustration, however, is the sense of crisis management that sometimes pervades day-to-day social work.
"Even if I have a list of appointments and home visits planned, I might get a call to deal with a crisis and everything else is pushed back. Sometimes the crisis work takes over and there isn't room for quality work with families."
The shortages of resources also rankles, with care plans drawn up for children which may never be fully realised because of a lack of services.
"You can find yourself referring a child to a psychologist and there's a year-long waiting list. In the meantime, their behaviour becomes worse and the child gets lost in the system. On top of that, there's competition for services.
"If I have a care-placement breakdown and my colleague has one, we're often competing against each other for the same service."
The shopping list of improvements for many social workers is long: it includes better mental health services, more family support, an increase in social workers, and more emphasis on preventative services.
Almost every sector in health needs to be expanded.
Despite these shortcomings, though, there are still many positives, says McCormack. Profound change often reveals itself in the smallest of ways. She sees it in the parents and children that she deals with every day.
"It can be a child having their first proper birthday party. Or Santie coming for the first time. Or maybe a child has got their first invitation to a birthday party. You can see the difference in children and how much it means," she says. "They might be simple things, but they're things that most families take for granted."