I recently travelled to Australia and New Zealand on a Churchill Travelling Fellowship, to learn from approaches to preventing child abuse and neglect in families with complex needs. By complex I mean families where domestic abuse, substance misuse, and mental health concerns are the prevailing issues, often compounded by social isolation, poverty, temporary housing and unemployment.
While there is widespread recognition that intervening early with vulnerable families can improve children’s life chances and break intergenerational cycles of harm, in practice it has proved difficult to truly prevent risks to children from escalating. Recognising that this is a highly challenging area without easy answers, I embarked on a journey to learn from policy, research and practice. Here are some of the ideas that emerged through my conversations with government departments, academics and practitioners.
1 A systemic approach to family support
Across different states of Australia and in New Zealand, I llearned about government-led initiatives which aimed to coordinate service provision, de-escalate risk, prevent referrals to child protection and create efficiencies through joint case working. Each approach was slightly different but had a central focus on prevention.
Mechanisms had been put in place by state governments to coordinate a response to families in need that work across systems, towards a set of agreed outcomes. There was the family referral service in New South Wales; services connect in Victoria; family support networks in Western Australia and children’s teams in New Zealand. The common features of these approaches are that:
- A lead agency takes responsibility for case management and the coordination of support for a family;
- Adult and child services work together, including health, education, housing, police, child protection, domestic abuse, and substance misuse services;
- A helpline serves to triage cases;
- A shared data system and outcomes framework is in place; and
- The aim is to intervene early to prevent issues from escalating.
These are ways of organising services around families, recognising that the issues they face are inter-dependent and it takes a joint concerted effort across multiple systems to intervene early in families with multiple needs. I don’t think this is news to anybody. In theory there’s an understanding over here too that, for example, poor housing affects parental mental health and children’s ability to thrive. But still agencies work in distinct silos, each responding to separate statutory guidance and local policy without seeing the family as a whole. Central to early intervention is the capacity to use data intelligently, to map families’ journeys in and out of a complex array of circumstances and services.
2 Innovation through co-design with families
Fundamental to early intervention in families with complex needs is a belief that parents have the capacity to change and provide safe and nurturing care for their children. The Australian Centre for Social Innovation (Tacsi) recognises that a strengths-based approach to working with families can motivate and inspire families with transformational results.
Family by Family was developed as part of an exploration of the child protection system and ways of reducing the numbers of children in care. A multi-disciplinary team was set up to work with statutory child protection services and a design team. Tacsi led ethnographic research with families to understand ”what’s hard and what helps…what’s the key to moving beyond just getting by, to thriving”. They spoke to a wide range of families in a specific community, and in response co-designed Family by Family, a peer support model that matches volunteer “sharing families”, who have been through difficult times to “seeking families” who need support. A family coach (usually a social worker) supports the process of sharing and seeking, but remains the professional in the background to give advice and guidance. The fact that sharing families have been through challenging experiences and are willing to help others overcome similar difficulties is key to the approach.
As well as learning about the co-design process, what I took away from this is that the rhetoric in the UK about families with complex needs has to change, starting with a strengths and assets-based approach to vulnerable families and communities. The evidence is clear that individuals are motivated to change when they have a sense of control and decision making power over their own lives, however limited that may be.
For families facing poverty, social isolation, unstable housing, domestic abuse, substance misuse or mental ill-health, the options for a better future are barely imaginable. Even less so if they have no model of alternative behaviour and relationships to refer to. The way that we speak about, write about, make decisions about and talk to children and families makes a difference.
3 Re-imagining communities
Prevention of abuse and neglect isn’t just about agencies working together to coordinate referrals, family assessments and a response. The voluntary and statutory sectors need to work in partnership to support local communities to create safe and supportive environments for children and families. I came away from my travels thinking about what it would look like to be working towards common outcomes in a local area, co-designing a systemic approach to family support that involves schools, children’s centres, the voluntary and community sector, health and social care commissioners, adult services and the child protection system. This would need to include data linkage across multiple systems to identify families’ entry and exit points; using and sharing the best available evidence of what works to protect children,and wide consultation with families to co-design solutions to community concerns.
The most inspiring conversations and approaches I came across were rooted in the principles of working with hope, empowering families to imagine a different future for themselves and their children. To facilitate this, bold decisions need to be taken to listen to children and families, respond with agile and flexible systems and processes and co-create more effective, evidence-based, and preventative solutions.
Jessica Cundy is development and impact manager at the NSPCC.
To find out more about Winston Churchill Travelling Fellowships, visit wcmt.org.uk.
Content on this page is produced and controlled by the NSPCC, sponsor of the Guardian Social Care Network practice hub.
