Does the State Have a Clue how to Look After Children Yet?

Jess Berentson-ShawTax and Welfare

The abuse of children while ‘in the care of the State’ in the 1950’s, 60s and 70’s in New Zealand is a dirty smear on our system of so called ‘child protection’. The excoriating interview of Social Development Minister Tolley is making waves for those at the centre of the abuse. The children who are now adults point out that, by ignoring key recommendations from the confidential listening service into the abuse, the Government is not attending to ‘what works’ for them.

I will not spend this post discussing how an independent inquiry for those who have suffered horrendous abuse during the most critical years of their development, could work to improve outcomes for them. What I will say is that without investigation into the scale of the problem (and we currently have no idea of the scale), what happened or why it happened, we have a vacuum of evidence of what went wrong in the system, whether we look like we are in danger of repeating that and how to apply the evidence to do better.

While Minister Tolley says there is no evidence it was a systematic problem, Judge Carolyn Henwood, who led the investigation states that:

“We haven’t investigated the department itself, we haven’t spoken to staff … there’s been no inquiry on the side of the thing, the ledger, so why wouldn’t it happen again?”

So the Government representative’s seems to be saying that because they have not looked at the evidence there is no evidence of a problem, while the chair of the listening service points out that by not looking at the evidence you have no idea of the problem you need to fix.

Hmmmm.

The big issue here is that without reference to the facts how do you know how to improve things for the next generation of children?

What we do know for sure is that the life outcomes for children in care in New Zealand are not a whole lot better today than they were for those children in care in the 1950s and 1960s.

‘It is doubtful children are better off in state care’

This is what the then Children’s Commissioner Dr Russell Wills said in early 2016 in the first report investigating the service Child Youth and Family (CYF) provides to our most vulnerable children. The Office of the Children’s Commissioner (OCC) concluded that the state is able to:

1) Identify children at risk effectively. (Well sort of, because the 8 children per year on average who are killed by their families have clearly slipped through the gaps);

2) Can remove children from that particular risk; but

3) Can do nothing to make the outcomes for those children better.

As parents, the state could well be just as destructive a force as parents who are deemed unfit. This is a pretty damning indictment of a system. And let’s be clear, it is a system – not individuals – that we need to focus on.

The OCC believes there is a problem with the system

The OCC report was pretty clear that most of those people working in the state system are dedicated and committed people, who at least start out with intentions to really help children living in some pretty grim circumstances. Sadly, the quality of practice delivered is very inconsistent, often due to insufficient training and skill. In addition, where pockets of high quality practice exist, the structures of the system overload them and fail to support those individuals doing high quality work. Overall, the system is not designed with the evidence about what we know would best improve the lives of these vulnerable children front and center. Outcomes for children are hardly even measured (so even if best practice was being delivered we would have no idea what difference it was having for children). What is really out of kilter is the finding that CYF does not always act with best interests of the child as its first and paramount consideration. The question remains whose interests are coming first if not the interests of children?

Who are these children in care in NZ that we fail?

In New Zealand at any one time there are around 5000 or so children under the care of the Chief Executive of CYF. This means that legal custody has been formally removed from families and given to the state due to care and protection concerns. It does not always mean the child is physically removed from a family’s care, but most often they are. They may be placed with other family members, or in foster arrangements and occasionally in residential care facilities. They are disproportionately Māori children, and they are more often than not poor.

2

 

If you want to know about the complex legal arrangements surrounding ‘looked after children’ you can read more here. And what are their lives like? To quote the Children’s Commissioner from early in 2016:

“Many have come from homes where violence, abuse and neglect are a feature of day to day life, where parents have failed to keep them safe, secure and well nurtured.”

Let’s not beat around the bush: some of these children have multiple issues and can be incredibly challenging to deal with. However, these children need more care, more love, and more attention than other children in NZ – not less – if we want them to have the same chances. The question that has consistently been raised is ‘Are they getting more & better care?’ Last year the Government ordered a review of Child, Youth and Family because of on going indications that the answer might be ‘no’. The OCC beat them to a result and says there is no ‘might’ about it. The Government has subsequently sort of agreed with that position

The situation for ‘Looked After Children’ has not improved much

Children in state care might not be at risk of abuse from their parents anymore but more often than not they are at risk of pretty much everything else. Research tells us that internationally and in New Zealand, children in care are more likely to have poor outcomes as adults compared to other children. They are more likely to be homeless, be involved in the criminal justice system, have drug and alcohol problems, and experience poor mental health and unemployment. Judge Andrew Becroft, the current Children’s Commissioner, has spent years highlighting what he calls the “staggering and profoundly concerning link between children who have been in care and crime”.

This staggering link between care and poor outcomes for children is demonstrated by data from the UK below.

screen-shot-2016-12-02-at-2-56-04-pm

Source: NICE, UK

Unfortunately, as the OCC noted: “CYF’s systems are not currently set up to measure and aggregate the information that matters.” So CYF’s does not actually have systems in place for us to understand what is happening to children in care in NZ, as we do internationally.

What we do know from the little bit of data we have is not good. Children who enter CYF care are eligible for a ‘Gateway Assessment’, which looks at the health and educational needs of that child and puts in place a plan to address these needs. Only 71% of children are getting that assessment. Of those who have been assessed, around 33% have emotional and behavioural needs, 12% have mental health issues, 12% have health problems like vision & hearing, and 25% have significant educational problems.

However, none of these children are being followed up with a formal monitoring system to record if there are any improvements from the interventions that are put in place as a result of the Gateway Assessment.

Would these children experience worse outcomes if they stayed with their families?

The one thing we have to consider is whether these children may have had even worse outcomes if they stayed with their families. It certainly is possible – these children were removed because the risk of severe physical and mental trauma was very real. However, there is no way to confirm whether they are worse off or not without doing a series of pretty unethical experiments; which would involve leaving some children at risk of serious harm with their families and comparing them with a group who were removed into care.

But this is beside the point really, because it is not good enough to just stop children being abused (which is clearly not the case historically). If we are going to go to the extreme measure of removing children from family care, we should be able to offer them a fair chance to experience positive outcomes in life – not simply an absence of parental abuse.

What does work for children in care?

Given these children are incredibly vulnerable at the time they were removed from their family many do need significant additional support to have a fair go at life. They need more than just standard parenting. Research indicates that intensive types of care for the children who are most vulnerable is required. Intensive care means much higher investment in staff training and in foster parent training, greater remuneration to those foster/interim parents dealing with the most vulnerable and challenging children, and a full team of skilled and capable support staff available to the foster parents – this includes social workers, psychologists, paediatricians, and other behaviour specialists.

These are some of the many things that are currently missing from the CYF system according to the OCC.

The biggest issue of course is prevention and there is clear evidence regarding investment in families and children even before birth as being the most cost effective way to give children the opportunity to thrive. The expert advisory group on child poverty has said it, we have said it, parents have said it.

The government has proposed a change to the current system of care, with the introduction of the ‘Ministry for Vulnerable Children’. The approach they are taking has not been met with enthusiasm, either within New Zealand or by those that oversee how we are performing in terms of our obligations under the UN Declaration on the Rights of the Child.

Will the new protection system attend to what works?

Here we come back to how do we know we will do better if we don’t want to know what went wrong before and why?

If the Government shows such reluctance to understand the facts as they currently stand how can we, the public, be confident they will adhere to the evidence and facts about what needs to happen to ensure best outcomes for children going forward?

Children have the right to better – the UN declaration on the rights of the Child of which we are signatories makes it the governments legal obligation- than what they are currently getting from the system. That means a greater commitment to understanding the problems and implementing the evidence than what we currently see. Believing you know what is needed without recourse to the evidence about what is actually needed and how to best achieve that has not proven a winning formula for New Zealand social policy to date. Why would that suddenly change now?

The last word goes to the children in care, for them something very simple is lacking:

“We felt in our experience that love was one of the main things that was missing a lot of the time”.

Can understanding and adhering to the evidence provide that love? No, but it can provide a better space and the opportunity for that love to occur.

Does the State Have a Clue how to Look After Children Yet? was last modified: December 2nd, 2016 by Jess Berentson-Shaw
About the Author

Jess Berentson-Shaw

Dr Jess Berentson-Shaw is a science researcher working for the Morgan Foundation. Jess holds a PhD in Health Psychology from Victoria University. Jess has over 10 years’ experience working on applying science and evidence to public policy. She worked on improving the use of science in public health practice in NZ, before working as a Research Fellow at University College in London, where she researched how doctors and clinicians translate scientific evidence into their clinical practice. While in the UK she also developed a national data collection system, which was used to determine what factors contribute to poor outcomes for women and babies during pregnancy and birth. On her return to New Zealand she directed a research group that specialised in the independent evaluation and application of research and science to health policy and practice. Jess loves science and what it can do to make the world a fairer place.