Most vulnerable children not getting help as soon as they need it

ANALYSIS:The first national review of child protection and welfare services shows the system is failing some of the most vulnerable children in the State

Social workers deal on a daily basis with the silent symptoms of society's failings: trying to help parents who fall through the cracks, linking them in with health and social supports or meeting the needs of vulnerable children whose safety or welfare is at risk.

It's a hidden world of families living on the edge of society, on the edge of the health system and, sometimes, on the edge of life itself.

Yet, despite the pivotal role they play, the system is operating against a backdrop of scarce resources, staff shortages and heavy caseloads.

That's according to the first ever national review of child and family services by the Health Service Executive (HSE), which shows an arm of the health service dominated by crisis management rather than early intervention.

The result is a compromised service which is affecting the quality of support available to vulnerable children and their families, and which flies in the face of official policy which states that children should be admitted to care as a measure of last resort.

As it is, the scale of abuse and neglect of children in society is frightening.

Child neglect remains the most common reason for children coming to the attention of social services. In 2005, for example, some 60 per cent of the 2,300 children taken into care had been neglected at home. Others were taken into care because of the inability of their parents to cope, or because of physical, sexual or emotional abuse.

The number of children deemed to be at risk has been rising dramatically in recent years, due mainly to increased awareness over abuse and the rising population.

Yet, as this report shows, many child protection and welfare teams are struggling due to ceilings on recruitment and the failure to replace social work staff.

For example, in the Blanchardstown area, one of the fastest growing in the country, the number of child protection and welfare referrals has risen dramatically. So too has the complexity of cases, many of which involve foreign national families or young asylum seekers disappearing from State care.

Yet, there has been no corresponding increase in the number of full-time social work staff to cope with the increased number of referrals, according to the review.

Staff are also saddled with the problem of referring vulnerable children to services such as speech and language therapy or psychiatric services which are burdened by long waiting lists.

In northwest Dublin, for example, staff were forced to commission independent psychologists to carry out parenting risk assessments as a result of long waiting lists in the HSE psychological services.

The shortages of resources and the large caseloads of social work teams is also leading to hundreds of children at risk of abuse or neglect not being thoroughly assessed by social workers. In "Dublin north", for example, a waiting list of 374 duty cases remained at the end of 2005.

These shortcomings can have profound effects. It means families in need of support are not getting it as soon as they need it, children with highly specialised needs such as speech and language therapy are stuck on interminable waiting lists, and children who never received early intervention are ending up in State care.

For some time the policy of health authorities has been to shift resources away from child protection - which tends to deal with emergency cases - towards prevention in the form of family support services.

This review points to some progress in this area, through Springboard projects and other community-based initiatives. But, overall, it says such services are patchy and underdeveloped. It also points out that a national family support policy, which would guide the development of such services, is still awaited.

The shopping list of improvements for social workers operating on the ground is long: it includes an increase in family support, more social workers, better mental health services and more emphasis on preventative services. Almost every sector, it appears, needs to be expanded.

The message of frontline staff is clear: if some of the most vulnerable children and families are to have any chance in life, it will take sustained funding over long periods of time.

Child protection: gaps in services

"The main deficit in child protection services is the very low number of social work staff . . . There is a significant challenge in finding suitable placements for children with particular and complex needs, eg addiction, sexually abusive behaviour, violence or mental health problems . . ." - Dublin West

"Due to significantly high case loads, children in care cannot receive ongoing desirable social work support and in many cases cannot receive prompt attention and intervention." - Cork/Kerry

"There are ongoing gaps in service provision for the monitoring and treatment of adolescent sex offenders. The impact of employment ceilings and the non-replacement of staff on extended leave caused considerable pressures to service delivery." - Cavan/Monaghan

"Many of these children for whom no placement is available have to rely on the provision of accommodation through the Crisis Intervention Service. This involves placing vulnerable young people in city centre locations." - Dublin South-East

"These waiting lists pose a potential risk to the young people involved." - Laois/Offaly

- Extracts from the Health Service Executive's review of adequacy of child and family services (2005)