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PAUSE Creating Space for Change
- 2. What do we mean by repeat removal?
- 4. First things first… Thank you!
- 6. The Scale of the Problem Between 2007-2014, 43,541 women lost their children as a result of care proceedings. Of this number, 7,022 were ‘repeat’ proceedings. We can consider all 43,541 women who record an index episode as ‘at- risk’ of a first repeat episode of proceedings… At least 24% of women are likely to return to court within 7 years
- 7. Maternal Age and Recurrence Teenage motherhood is associated with recurrence Maternal age is a risk factor for recurrence, with the youngest women most likely to record multiple repeat episodes Young women may experience an index and first repeat episode before they exit their teenage years
- 8. Need for change for women, their families and the community • Where a negative cycle of recurrent care proceedings remains unchecked, prognosis for recovering parenting capacity is believed to be poor. • Care proceedings get shorter over time, often women are already pregnant again during care proceedings trying to replace what has been taken from them (Broadhurst, Harwin and Shaw 2014). • There is decreasing opportunity for change once a mother is caught in this cycle. • Research has identified that looked after children and young people are several times more likely to have a statement of special educational needs, to experience mental health problems; to be excluded from school and to be NEET. Careleavers are more likely to end up in the criminal justice system, as victims and perpetrators. They face adverse outcomes across the lifespan: in work and education; in chronic physical and mental conditions.(McAuley, Pecora and Rose 2006). • The women that meet Pause criteria are likely to be regular sporadic and reactive users of other local services including that of Housing, Substance misuse services, Health care and Mental heath services, Probation and Criminal justice services and Domestic abuse services. • They are less likely to be engaged in preventative care and support. Helpseeking is one of their primary difficulties.
- 9. Southwark
- 10. 123 Women 377 children removed
- 11. Southwark statistics (21 women) 100% have experienced violence within relationships 26 % have alcohol issues 47% have a history of being in the care system 37% have substance misuse issues 100% have experiencedmental health difficulties 32% have a diagnosed learning difficulty 75% have housing difficulties 25% have been in contact with the criminal justice system 58% have a history of sexual abuse or exploitation
- 12. 487 372 0 100 200 300 400 500 600 London-Southwark London-Haringey London-Lewisham London-Lambeth London-Greenwich London-Ealing London-Barking & Dagenham London-Newham London-Camden London-Tower Hamlets London-Islington London-Brent London-Hammersmith & Fulham London-Croydon London-Waltham Forest London-Barnet London-Hackney London-Hounslow London-Enfield London-Bromley London-Wandsworth London-Bexley London-Westminster London-Hillingdon London-Havering London-Sutton London-Merton London-Redbridge London-Harrow London-Kensington & Chelsea London-Kingston-upon-Thames London-Richmond City of London Number of care applications LocalAuthority
- 13. 32% 22% 0% 5% 10% 15% 20% 25% 30% 35% London-Southwark London-Lewisham London-Enfield London-Waltham Forest London-Barking & Dagenham London-Redbridge London-Kensington & Chelsea London-Greenwich London-Bromley London-Tower Hamlets London-Bexley London-Islington London-Newham London-Croydon London-Havering London-Camden London-Haringey London-Hammersmith & Fulham London-Hounslow London-Wandsworth London-Harrow London-Lambeth London-Ealing London-Barnet London-Hackney London-Brent London-Merton London-Sutton London-Hillingdon London-Westminster Percentage of applications linked to recurrent mothers LocalAuthority
- 14. Lack of Access to Support • “Not good enough” to parent, “not bad enough” to qualify for services – and deeply mistrustful of professional help.
- 15. £34,870 Annualprison costs per prisoner £7190 Cost of 10 arrest & detention incidents per annum £6730 Cost of 10 anti social behaviour incidents £28,360 Cost of 10 domestic abuse incidents A few more costs: Health, Police & Prison Services £6,800 Cost of 20 A&E attendance & ambulance service incidents
- 16. Collateral Consequences Diminished psychological social and economic well- being Changing welfare entitlements Informal social costs Legal stigmatisation Role loss Grief
- 17. Loss of welfare entitlements and informal social costs • Loss of home – forced move ‘bedroom tax’ • Loss of benefits • Sanctions on kin relationships (contact) and potential exile from informal parent networks
- 18. Maternal Identities • Ongoing identity as mother even where child is adopted and no ongoing contact • Ongoing identity not adequately acknowledged • Holding out for child returning as an adult • Visual representations • Contact arrangements and perceived relationships with alternative carers important
- 19. Legal stigmatisation Family court history – is never ‘spent’ Particularly pronounced for care leavers: 47% women interviewed had spent time in care system Felt under particular scrutiny by state Deep mistrust of system Fear “Punishing me twice”
- 20. Why do things differently? • Financial cost – across all systems • Human cost – children, families, communities, and women. • Because the ‘bad mothers’ of today were yesterday’s hurt children. • And fundamentally, because it is not too late. • Each one of our women is extraordinary and frankly, we don’t want to miss out.
- 21. Costs: Children services £14,397.06 Annualcost of Pause per woman £27-43,000, Minimumcost per adoption case
- 23. CONTACT ACTIVITY (Around 8 weeks) LARC & ONGOING INTERVENTION (maximum 8 weeks from agreement ONGOING INTERVENTION (Around 10 months) 18 MONTH PAUSE PROGRAMME PAUSE Timeline of Support INITIAL CONTACT AGREEMENT LARC IN PLACE TRANSITIONAL WORK (Around 4 months) TRANSITION OUT OF PAUSE COMMENCE TRANSITIONAL WORK
- 24. What Pause does and does not do . .
- 25. Hull Newcastle Birmingham Bristol National Programme Key Blackpool Derby Cork Current Pause Practices In development Scoping exercises in progress/planned Other Leads and interested areas Slough Scotland Northern Ireland Cumbria St Helens West Sussex Wiltshire North East Lincolnshire London Cardiff Liverpool Wigan Sunderland Morpeth Durham Medway Peterborough Rotherham Maidstone Truro
- 26. What Pause does…
- 27. Projected Spend £906,844 Pause Budget £428,535 Without Pause With Pause Projected Cost Avoided £478,309 • 29 women over 18 month period of intervention • Birth rate of 0.53 per year • No pregnancies & babies removed into care Pause Hackney: Cost Benefit
- 28. Working in arenas where mistakes are the territory • Our women have usually made many, many previous attempts to make friends, start courses, stop drugs or drinking, get help with mental distress, gain housing, move away from destructive relationships. They often lack resilience skills – they make a lot of starts and give up easily. They may be at the pre-contemplative stage of the cycle of change. • This is often reflected in services’ engagement with short bursts of support followed by eviction, disengagement, discharge or expulsion. • Our work requires practically linking women into housing, drug and alcohol help, mental health input, and breaking away from problematic relationships. • But the efforts they make with us will be one in a long line of efforts. How do we make this effort different?
- 29. A fundamental shift in approach Mistakes, lapses and setbacks are not the things that take us off map Mistakes, lapses and setbacks are the territory: they are what women, systems and services need to learn to navigate.
- 30. What we know about the consequences of ACEs • Brain is not the problem • The problem is • Resilience • Connecting
- 31. Reflecting and connecting • We target increasing reflective and connective capacity – because if we can connect with someone when we’re hurt, pain lessens, and when pain goes down, we open up space to learn • and learning from things that go wrong is the difference between adaptive and maladaptive. • At Pause Southwark, we positively reward relating – we want women to associate both being reflective and communicating with feeling safe (emotionally and relationally), feeling understood, feeling important, respected, intelligent, and with laughter, safety, kindness and trust.
Notas del editor
- Self explanatory – Creative example of her narrative and Pause providing an alternatve narrative for her Life story Developed with her Pause practitioner – explain who Linsay is and how this came about Importance of this example
- We’ve learnt over the last 12 months and as we come to the end of our first cohort, that the most important bit in supporting change for women at risk of repeat removal is YOU. And moving on, the systems around the women will be the difference between success and failure. We’re going to be celebrating some of the people who’ve made a huge difference to Pause women, and we’re going to be inviting everyone to consolidate on what they have already given and help us think creatively how we can continue to do things differently for Pause women, to end the cycle of repeat removal.
- Variation in care applications – London Boroughs
- 11% to 32% is range across London Boroughs Range across England is 11% to 39% based on local authorities that have recorded more than 100 care applications during the observational window. Adjustment required to ensure comparability of local authorities – future work.
- Quant shown these widows but we don’t know whats going on our qual datashows whts going on at this time.
- Integrated and systemic model Woman at the centre Assessment developed with her , understanding her history and also what are her current needs, what she wants to do differently Practitioner – role to understand the issues Know about children, when removed etc Use of genograms and ecomaps- triangulat what we know with other agencies Plan developed with her – collaborative May need to focus on primary needs in first instance – Maslow – basic needs first as opposed to “ counselling “ being seen as solution Use of tools and evidence based approaches Her experience of assessment Integrated needs but role of practitioner not to “ signpost “ Relationship being key Womens resource – why key – how can be used
- How we locate women – data in local area Don’t rely on referral system in the first instance and why 16 weeks to make decision around working with Pause and taking LARC Challenges of locating the women Talk though- intensive focus around contact activity – identifying women, going out to try and locate them, engaging them in potential support from Pause, undertaking initial assessment of the current needs/ risks and strengths and what they want to achieve through intervention Focus on relationship building and dealing often with multiple crises which may be around housing/ mental health/ outcome of proceedings, contact, relationship issues Need to be clear around language re consent/ agreement / sharing information If women come off LARC or become pregnant , what do we do Peaks and dips around intervention – much around stabilisation in early period and developing relationship Transition phase should be well planned, considered and involve the woman – into other services, doing on her own , foundations, better equipped, different decisions, less crises, experience of help seeking, reducing risks inc future pregnancies resulting in removal and children into care Day in the life of a practitioner and what this could look like in terms of types of intervention being provided Approaches being used Tenacity, use of self . Creativity, reflexivity, doing with , modelling, navigating systems and bureaucracy, role modelling, stabilisation , women's identity – maternal identity, other needs and focus on her, plans being developed with her in mind / alongside her/ with her/ The relationship between the practitioner and the woman she is supporting is key. Develop professional, supportive, non-judgemental accepting relationship. Our work requires practical support in linking them into services; attending with them, advocating for them and modelling how to navigate systems. Doing for, doing with, supporting to do and cheering on - providing positive reinforcements and empowering independence. We work to increase reflective and connective ability, which enables the women to become aware of themselves, their relationships and make better informed choices and decisions. Being curious and learning through positive experiences which leads to increased skills and confidence and new ways of behaving and achieving You might want to make reference to use of the women's resources- how this can help with practical things as well as positive experiences that they may not have had access to, Doing with – examples of the practice – bike riding, gym, bread making and cooking, creative activities, going swimming Creativity