Children who are killed by their parents; we still have so much to learn…

children-were-classed-as-being-in-poverty-if-their-family-s-income-fell-below-60-of-the-median-average-income-143067855

I do not tend to watch TV programmes about social work (not that there are many of them) as they tend to either bore me or make me angry. Last night, this one was a major exception.

The documentary did not say much that I did not already know- I have reflected on the tragic story of the death of a boy known as baby Peter many times on this blog, in an attempt to tell something of the complexity of attempting to protect children through bureaucracy, and my total frustration at the vilification of my profession (social work) as being somehow culpable for what sadly what is an all too frequent occurrence.

Around 260 other children have been killed by their parents since Peter died. We do not know their names. Many of them were also known to services.

The difference in this case is that the press decided that scapegoats were required. They made no effort to understand, to engage in debate about the nature of the task, to understand the inter-relationships between agencies, to consider the resources that are being applied to the task and whether they are adequate or appropriate.

The story that they chose to create was one of the failure of social workers, and to a lesser extent, a ‘foreign’ doctor. Three social work staff, including a rather brilliant director (Sharon Shoesmith) were destroyed in the public eye.

Politicians, particularly David Cameron and Ed Balls then weighed in- one to make political capital, the other running scared of The Sun newspaper and the Murdoch empire.

It became a witch hunt.

If you want to understand how organisations attempt to protect the most vulnerable members of our society from those who should be their closest protectors, then you should watch this programme.

Watch it to understand how things go wrong, but remember too that many many children do not die, because of the intervention of these very organisations, and the dedicated staff who work within them.

You might like to check out some of my earlier posts on this subject;

Here,

here, and

here.

Reflections on going backwards…

William walks the sands

Most of us measure our lives by the progression of a career.

We start out with dreams; spaceman, nurse, vet, train driver, deep sea diver. These dreams are fed or squashed by teachers, parents, careers officers. They tell us it is all so serious, so crucial; we have to find the right path.

So we stumble forwards through school exams, college courses, university. The pressure is intense. Each threshold contains the possibility of complete failure.

But most of us make it through to some kind of job. The bottom rung. The starting block in the race of life.

About a quarter of a century ago I started my first job as a social worker. I was 23, naive and desperate to do something that mattered- to mask my own brokenness behind (often futile) attempts to mend others. I worked hard in a small team under intense pressure from inner city problems that most people would never believe existed. Most of my colleagues buckled under the strain- none of them are still working in social work.

As I too began to come apart at the seams, I also progressed my career. I became a specialist, then a therapist. Later I became a team leader, then an area manager. I was climbing.

Except that when you climb higher into the machine, what you find is not a more finely honed sense of what social work is all about. The idealism that took us into the profession is gone. The value base that we espouse (person centredness, an identification with the poor and those in need) has largely been forgotten. These things are not measurable, have no performance targets, so have no worth in this new world.

You also find that power attracts a certain kind of personality. Some people seem born to trample on the fingers of others and call it good management. The games that we play to win pointless hollow victories. The damage we do to each other (and to ourselves.) Often, quiet competence is punished, whilst those who can play the power game advance. It came to a point where I felt myself neither competent nor able to raise myself to scratch for power, so I got out.

But I still need to make a living, so eventually I find myself doing agency work, back at the bottom of the rung. From one perspective, the last 25 years never existed. I have gone no where, done nothing.

Meanwhile I am looking at applying for permanent jobs with salaries that are less than I have earned for more than a decade. And it is all rather sobering.

winding road

However, I am still having to learn over and over that life is NOT about rising up, succeeding, earning ever more money. This kind of life is one that is killing the planet and making us all unhappy.

What I am learning again are the simple pleasures of doing something because it is good. Listening to people’s stories with ears wide open. Meeting people on the edge and encouraging them to shuffle back a bit.

Life is not lived in straight lines. Thank God.

On prosecuting parents for emotional abuse…

boys on a mission Over the decades working as a social worker, I have worked mainly with adults, often who were suffering the consequences of a childhood in which they have been damaged almost beyond repair.

Of course there is rarely, if ever, a smoking gun. We can surmise that some of the experiences are causal, not just associations, but proving this – separating it from so-called genetic disposition, or from weakness of personality, or the consequences of all the maladaptive coping strategies that we use to get by, and then become the slave of – this is another matter entirely.

It will not surprise you then to hear that I have been more than a little interested in the recent news that the government are to introduce a new criminal offence in relation to the emotional neglect of children. Robert Buckland, the Conservative MP for Swindon South was quoted in the Guardian as follows;

Buckland said: “Current law focuses only on the physical effects of abuse, stating for example that it is an offence to ill-treat a child resulting in the ‘loss of sight, or hearing, or limb, or organ of the body’. Emotional neglect, by contrast, which modern science now shows can be equally as destructive to a child’s wellbeing as physical abuse, is excluded from the law.” Action for Children said that out of 41 legal systems examined around the world, only two, including England, did not criminalise emotional abuse.

It is worth remembering the rather shocking research results about the link between emotional abuse and the later development of psychotic illnesses- Oliver James in the Guardian said this;

definitive analysis of the 41 best studies into the impact of childhood adversity on the risk of psychosis (mostly schizophrenia and bipolar disorder) was published in 2012. It broke down the role of different kinds of maltreatment. Emotional abuse meant exposure to behaviour such as harshness and name-calling from parents. Emotional neglect meant lack of love and responsiveness. Overall, in order of impact, emotional abuse increased the risk of psychosis the most (by 3.4 times, physical abuse and emotional neglect did so by 2.9, sexual abuse and bullying by peers by 2.4).

That emotional abuse is more damaging than sexual and physical abuse may seem surprising, although they tend to go together. One study found that the emotionally abused were 12 times more likely to be schizophrenic than the general population (compared with six times for the physically abused and twice as likely for the sexually abused).

Another study followed adolescents for 15 years and found that over a third became schizophrenic if both parents were hostile, critical and intrusive, compared with none where only one parent was or neither were.

In his definitive book, Models of Madness, John Read, a clinical psychologist at Liverpool University, shows that in the 10 studies testing the matter, the more extreme the childhood adversity, the greater the risk of adult psychosis. The results are similar for the number of adversities.

In one large study, those subjected to five or more adversities were 193 times more likely to suffer psychosis than those with none.   Similar findings come from studies of less extreme emotional distress. In the definitive one, which followed 180 children from infancy to the age of 18, 90% of those who suffered early maltreatment qualified for a mental illness. Emotional neglect under the age of two was a critical predictor.

It is in light of this evidence that the government’s plans must be understood: the crucial role of early nurture seems to be accepted in a cross-party consensus.

Why then do I still find myself with an uneasy sense of foreboding about all this?

I think it is because child protection in this country has been characterised by such simplistic banner waving. We are desperate to find someone to blame; the reason children are abused is because of all those horrible people (who are not like us) who need to be sorted out. If only the bloody woolly liberal social workers would get out of their bloody CND meetings and do their bloody jobs.

I also know just how incredibly difficult it can be to firstly identify the damaging patterns of parenting that might be categorised as emotional neglect, or even emotional abuse. Add this to the growing awareness within child protection services of the association between parental mental illness and emotional neglect. The fear is that the perfect storm of political pressure and the desperate need to protect children might end up demonising and criminalising parents who are themselves needing help and support.

This recent Ofsted report kind of makes the same point- back in 2013, they called for a mandatory reporting system for mental health services to collect data on children whose parents or carers have mental health difficulties and report on such data nationally. What might we use such data for? My hope is that it would be to assist families. To get alongside young people and find ways of making them feel special, loved, accepted. For injecting a sense of delight and wonder into their childhoods. But this is no easy task either.

These are complex issues, requiring careful thoughtful engagement. The law is part of this, but it is a blunt instrument- applied when it is actually too late. Suggesting that such a law will operate as any kind of deterrent on people who are often affected by their own complex difficulties is fanciful in the extreme.

When will politicians stand up and trumpet a the unsexy quiet work of the family link workers, paid just above minimum wage, who hold the hands of children who most of us would never give a second glance?

Uncle Tom…

paper-chain

 

Uncle Tom

 

When I was born I was blue from cold

The midwife borrowed coal

 

I had two mothers; one flesh

The other sent us giros

Fed me vitamin-enriched orange juice

With my free school meals

That generation did not reverse disadvantage

But they held it at arm’s length for a while

Whilst I was educated above my station

 

But I could never forget that borrowed coal

It was a debt of compound interest

A life of social service could be the only

Appropriate gratitude

 

25 years later I am darkened by doubt

Did I became a kind of Uncle Tom

A white bureaucratic house-negro

Keeping my kind compliant

At the shrinking fringe of the welfare state?

 

Did I offer cheap ointment for chain-chafe

When I should have swung a hammer?

 

Unlike Tom I will not go quietly

 

 

Sharon Shoesmith and the shadow cast by the death of children…

sharon-shoesmith-415x275

I have written quite a lot on this blog (see here and here for example) about the tragic death of Peter Connolly, known as ‘Baby P’. Although I have never worked as a full time child protection worker, I know enough about the inner workings of social work departments as they try to protect vulnerable children and adults to find a reflective distance on all that has flowed from these dreadful events. The events went something like this;

April 2007, concerns raised about parenting. Investigations started, child placed on at risk register

June- SWer raised concerns about injuries. Suspicion that these were non-accidental, but no evidence. Specialist medical assessments not conclusive. ‘Fell on stairs.’

Hv’s Swer visits- not enough to meet threshold for care proceedings- three multi-agency child protection conferences. Robust discussion (police later said ‘we told them to take action’) but course of action agreed by all.

CPS- not enough evidence for charge for neglect- this decision made the week the child died. Baby P seen Monday be SW, Wed(medics), Thurs, SWer again, Friday, dead.

At some point over last 48 hours, there was a brutal attack on the child. Swers had no knowledge of the two men living in the home- partner and lodger. Boyfriend hid when professionals visited- in a wardrobe and also in a trench in the back garden! Went to great lengths to hoodwink professionals.

The mother gave the impression that she was willing to work with staff- leading to optimism.

Then the media stuff exploded. The story became about Shoesmith- she was the visible face of criminal neglect by (primarily at first) social workers.

Later investigations launched into health services and police, finding significant failings. Media not nearly as interested.

Ofsted and government departments knew what had happened days after- they were informed. Serious case reviews happened, made recommendations. Months later (as the press and political response gathers like a storm) ofsted chose to make another inspection, which can be read here. They gave no prior warning of the contents of the report or opportunity to discuss the accuracy of the findings to Shoesmith prior to publishing- very unusual. The report was in stark constrast to earler findings by the same agency.

Since these events, numbers of children being removed from families and taken into care have doubled.

At the same time, child protection departments are finding huge problems recruiting social workers to do the work- Birmingham social work director recently described children in his area as ‘not safe’ because of their problems recruiting.

Yesterday there was another twist in the case. You may remember that the Director of Haringey social services was summarily sacked by the then Children’s Secretary Ed Balls.  It was then no surprise to me that the previously highly regarded Shoesmith won her case before an industrial tribunal.

It appears to have been a surprise to Balls though, who said this yesterday (see BBC report here)-

“An independent report said there were disastrous failings in Haringey children’s services. They said the management was at fault. Sharon Shoesmith was the director of children’s services and so of course it leaves a bad taste in the mouth that the person who was leading that department, and responsible, ends up walking away with, it seems, a large amount of money.”

Well that is what happens Ed when your actions are described like this be the court of appeal;

The Court of Appeal concluded Ms Shoesmith had been “unfairly scapegoated” and her removal from office in December 2008 by the then Children’s Secretary Ed Balls had been “intrinsically unfair and unlawful”.

I heard recently that the average length of a doctors career is around 28 years. The average length of a social workers career is (wait for it) 8 years.

We start off with such hopes- we can make a difference, we can do a job that is genuinely based on helping others, on making lives better, on reaching into the mess of humanity and saving people from destruction. Pretty soon we realise that we do very little of these things- we become bureaucrats, societal police. We are pushed towards engaging with people not as humans, but through the machinery of state. And most of our time is spent in front of computer screens punching in data, much which is done to ‘cover our backs’.

One interesting fact about soldiers fighting in wars appears to be that when wider society does not support the war effort (think Vietnam or Iraq) then cases of post traumatic stress disorder go way up. I have known a whole lot of social workers who have come apart at the seams.

My first job was as a mental health social worker in busy metropolitan Bolton. Dreadful things happened weekly- murders, suicides, drug addiction, violence. We discovered people living in terrible squalor and tried to form relationships with people who had forgotten that such things were possible. We worked really hard, and I would say with hindsight did some pretty amazing work given the resources and circumstances of our practice.

There were 4 of us were in my small team. One was well on the way towards being sacked as he was becoming increasingly erratic, before he was attacked by a man with a hammer. He never worked again. Another had a mental breakdown and became manic. She lost her social work registration, and still has problems seeing the world straight. She works now as a part time support worker. Another man had his problems with depression, before becoming a social work trainer, then retiring.

I am the only one of the four of us still working as a registered social worker 20 odd years later, and I am not pretending to have got away free of damage.

And we did not work directly with children.

I talk about these things not because I am out to curry sympathy, but more because what social workers do in our society no one else does. We need to decide then whether what we do is a valuable part of how our society works, and if it is, whether we are happy to see a group of trained professionals who have developed skills and a firm value base continuing this, or…

There is evidence that things may be turning. David Cameron actually got a round of applause for social workers at the Conservative Party Conference this year. There is talk of investing in new training (but reducing it to one year. Social workers currently train for 4 years.)

As I have said before however, do not pretend that babies will still not die at the hands of their abusers. No system will ever prevent all deaths. And hindsight will always tell us that things could/should have been done. Remember instead all those other children who are alive because of what social workers have done- and consider what you would have done in their place.

Home care

old-hands

This story has been on my mind over the last few days.

Increasingly, old people in this country are cared for at home. In some ways, we can be proud of this- people no longer go ‘into a home’ as they become more needful of care, unless they need ‘nursing care’ (which is often a rather ambiguous distinction however.)

This means that increasing numbers of older, frail people are living in their own homes, dependent on electronic monitoring systems and visits by care workers to assist with meals, toileting, even transfers from bed to chair.

And here is the problem. The cost of all this care is squeezed so tight that care workers have tiny slices of minutes before rushing on to the next home. Home care workers have long stopped all activities that are not deemed to be entirely necessary for physical care (cleaning, socializing, sitting with a cup of tea for a chat, shopping.)

Leonard Cheshire care have said that they will no longer participate in any contracts that slice care into 15 minute slots. Good for them. However, the real issue is the degree to which we allow care for our elders (the carriers of wisdom, learning and knowledge) to default to such a low common denominator.

Most home care is now provided by private or voluntary agencies whose workers are probably the lowest paid people in society. Councils are constantly trying to find ways of driving costs down, by re tendering or raising the thresholds for what they will provide. They describe the very real economic factors that force them to do this- reduced funding from central government, increased numbers of older people requiring care etc. These are complex, difficult times for social care provision and let no one pretend that the fault lies with the people trying to manage the front line of care. Some of the people (almost exclusively women) who do the hands on work are, in my opinion, only one step removed from sainthood.

But, forgive me for making a rather cliched simplistic point- Trident nuclear submarines cost about £2.5 billion per annum.

And another one- would an extra pound of tax per month from your wage slip make that much difference?

These are economic decisions that our government regards as politically unacceptable.

Yet we can live with the loneliness and isolation we inflict on our elders.

Home Care

.

The world has become these walls

Covered in pictures of what we once were

Before your heart stopped beating

Some days she hears him whispering

Pulling her closer

No regrets my love-

Just all our memories

Cradle to the grave

.

Each morning she waits for chemical relief

The meat of her is in rebellion

Each joint swollen like wet wood

Each vein pumping pitch black blood

Skin like a stone dressed in lichen

.

There is the rattle of the key from the keysafe

She stiffens, steels herself for dependency

As a stranger in a green tabard clamours in, high on bonhomie

The clock starts

.

How do I use of my fifteen minutes?

A hot meal or a warm bath?

That commode is unmentionable

What was it they said about having to pay for domestic care?

How did it get to this?

.

Then the girl is gone

And she sits alone again

Before her wall of memories

Why can’t we work together to stop children dying?

daniel pelka

So, another serious case review is convened to investigate the tragic circumstances of the death of a child at the hands of his parents.

This from The Guardian back in August. It makes for gut wrenching reading;

The mother and stepfather of Daniel Pelka will each spend at least 30 years in prison after a judge told them they had waged an “unprecedented” campaign of cruelty on the four-year-old boy.

Mrs Justice Cox said Daniel looked like a concentration camp victim at the time of his death and on the evening he suffered the fatal blow to his head had been force-fed salt and subjected to a form of water torture, which would have left him “terrified”.

The judge said it was possible the little boy, who was left to die in his filthy box room at the couple’s home in Coventry, may have been “lucid” after the final brutal beating and would have suffered “fear, anguish and physical pain” before losing consciousness.

She told his mother, Magdelena Luczak, 27, and her partner, Mariusz Krezolek, 34, that one of the most aggravating factors was the “chronic and systematic starvation” Daniel endured in the last months of his life.

“Both of you deliberately deprived him of food. He was literally wasting away,” she said. “His starvation was so chronic that his bones ceased to grow.” The judge reminded them that experts said during the trial that they had never seen such emaciation in the UK. “They likened his appearance to those who failed to survive concentration camps.”

Faced with stories like this, we first ask how on earth parents could do this to a tiny child. What kind of depravity could bring someone to such evil? Are they mad, or just bad?

Next we ask another question- why was nothing done about it? How come in this modern age, with billions spent on societal supports like social work, health, education and police, still we could not save this boy?

The most high profile case of the blame game that then follows on from these dreadful incidents was that known as ‘Baby P’. I have written extensively about this case- here for example. In this case, the media and the then Labour goverment (particularly Ed Balls) competed with each other to heap burning coals on the heads of people involved- particularly social workers. The arguments over how this tragedy became politicised and spun by a government on its last legs rages still.

Early signs are that we currently live in different times. David Cameron actually praised social workers in his speech at the recent Conservative Party Conference- which ironically contained many other policy statements that will fill social workers with rage and despair. The mood at present seems to be to accept that the nature of the social work task is incredibly difficult and that perhaps we can never save all children. There was another brilliant piece in The Guardian that tries to dig into the psychology of what happens when a social worker is faced with the messy reality of a family in difficulty (sorry, I know most of my references come from here, but it is my daily read!)

These were not bad or psychologically flawed practitioners; they were outmanoeuvred by aggressive parents, and overcome by the suffering and sadness in the atmosphere of such homes and in children’s lives. The case review on Daniel refers to how his home “was clearly one with a tense and sometimes violent atmosphere”. Caught up in such atmospheres, social workers become overwhelmed by anxiety and lose their purpose and focus.

Teachers, who tend not to visit the home, can be immobilised by how parents project into them their rage, lies and irrational beliefs – such as Daniel’s supposed eating “obsession”.

The case review concludes that Daniel “must have felt utterly alone and worthless … At times he was treated as inhuman, and the level of helplessness he must have felt in such a terrifying environment would have been overwhelming.” Perhaps the most painful truth that must be confronted is that, faced with the helplessness of children, social workers themselves can become helpless because they find the children’s suffering unbearable.

Every time we take a postmortem examination of the what when an why of one of these tragic incidents, there is a depressing familiarity about some of the conclusions. We always see ‘missed opportunities’ when professionals might have acted differently.

The other conclusion that might be inked in before the serious case review begins is this one- agencies will not have been seen to work together closely enough. They will not have ‘communicated’ or ‘co-operated’ effectively.

Why? It sounds so petty does it not? I have been reflecting on my almost 25 year social work career and trying to understand what this is all about. Here are my thoughts;

  1. Co-operation is about relationship. If you allow relationships between key people in different organisations to sour, it becomes almost impossible to work together. Everything stops. I can think of times when I have nurtured by dislike of opposite numbers, to the detriment of our respective services. I can think of other times when I have gritted my teeth and refused to allow myself to take offence, and I am much prouder of the latter. I have been part of a work culture however that operated in almost constant conflict and suspicion at high levels. This is a toxic mix that is almost psychopathic and is certainly highly dangerous.
  2. Under pressure, it is very easy to play the responsibility game. It is a very human thing- none of us can do everything, and when we perceive something to be the primary responsibility of someone else, we defer to them mentally as well as physically. This means that we tick boxes and pass them in them over, or we perhaps assume that they are attending to aspects of the whole that excuse us- after all there are usually a thousand other things clamouring for our attention.
  3. Different organisations have their own jargon, their own sub cultures. These greatly affect not only how they understand a particular set of information, but also how they respond to it. Some organisations revert to ‘doing it by numbers’, in an attempt to make sure that they are covered. This only succeeds in managing responsibility, it does not really save lives. Real people are messier than a checklist or two.
  4. Organisational cultures and value bases lead to in/out group mentalities. We are skewed towards suspicion of the other. Which makes point 1 all the more important. I have worked in situations in which the police actively denigrate social work and where social workers regard nursing colleagues with contempt.
  5. Sometimes people simply fear over reaction, or lack trust in partners to act in a way that they feel would be competent. There has long been a suggestion that if you tell a social worker about a child in need they will whip kids into care far too fast. The irony is that we now remove a far greater number of kids because of criticisms about the death of children when we have NOT done so. This culture has shifted but is remarkably persistent.

Are these things to blame for the death of children?

No, the cycles of damage done and received by individuals are cause the death of children. Drug use, alcohol use, broken people who break others. The blame game often answers few questions about why.

However, there is no doubt that some things will make it harder for us to co ordinate our efforts to save kids.