As public sector cuts take hold,Anne Longfieldargues that successful early intervention is needed more than ever to help families in crisis - and that Children's Centres and health professionals can play a key role. With 4Children taking a lead on early years and childcare policy, her argument carries some weight
When we at 4Children closed our 18-month inquiry into family life in the UK last October1, one of the clearest messages we heard from families was the unconditional love they shared for one another and their concern for each other's welfare. Even families in crisis had an overwhelming desire to do the best for their children.
This led us to ask how these good intentions could be directed to help prevent families falling into crisis in the first place. When questioned on their experience of falling into difficulty, families told us that more guidance and support earlier on from professionals who they could trust and were "on their side" could have made all the difference, and prevented them from entering the complex system of state intervention. Every year, 28,000 children are placed in care2, with millions more having their chances of success diminished by growing up in families who are struggling to cope with complex problems. With the vast majority of parents wanting the best for their children, the challenge we all face is how to support these good intentions with the practical help and support that many parents need to prevent family problems spiralling out of control.
Family crisis reaches a critical level
The need to provide pro-active, welcoming support to families to help build resilience and prevent breakdown is not only relevant to the two to five per cent of families facing complex and multiple challenges. Research for the Give me Strength campaign shows that serious problems are widespread with just 17 per cent of families surveyed having not experienced at least one of a list of potentially life changing events3. Firstly, we need to be honest about this so that families don't feel they have to suffer in silence for fear of being branded a failure. Secondly, we need to develop a new approach to family support which builds on families' strengths and provides help before problems become more serious. Families we speak to consistently tell us that help and support was nowhere to be found until crisis point hit, at which stage they felt the state was suddenly 'on their backs' making them feel like 'failures'. The central goal for our new Give me Strength campaign, launched in May 20114, is to ensure that families have somewhere to turn where they can access non-stigmatising support to give them the strength they need to work through life's problems and be involved in creating their own solutions.
Prioritising early intervention
As well as pro-active, universal support for families being in the interest of building stronger, happier families, there is an equally rational financial imperative as to why intervening early is an urgent priority. There is a misguided belief among some that universal services are unaffordable in times of economic austerity. In fact, the enormous costs involved in dealing with families who are already in crisis are so high that a shift towards investment in prevention is the only viable economic solution. And as most practitioners know, universal services which do not carry the stigma of 'failing families' stand the best chance of engaging the most vulnerable families who need the support the most.
In 2009/2010 around £3bn was spent on looked after children's services in England with each child being looked after in a children's home costing around £125,000 each year (£25,000 for each child placed in foster care)5. Children looked after in secure accommodation generate a cost of £134,000 each year6.
To compound the problem, the number of children being placed in care is on the rise and has increased by seven per cent in the last five years to 64,400 in the year ending March 20106. Many of these cases could have been avoided if help was made available earlier to help their families work their way out of difficulty. The current approach is unsustainable and at a time when anecdotal evidence shows that local budget cuts are leading to funds in some areas being directed primarily into crisis management rather than preventative services, the need to speak up for early intervention has never been stronger.
Crash Barriers assesses risk factors
To coincide with the launch of Give me Strength, we have published a new policy report, Crash Barriers7, which details practical recommendations for putting early intervention and prevention into effect. Crash Barriers provides the rationale on the first steps towards making early intervention a reality by proposing three priority parental risk factors that should be tackled as a priority to prevent family crisis.
We believe that there is an urgent need to develop a new response and understanding of these issues because they are particularly prevalent; occur in families across the social spectrum; they can have a more detrimental long-term impact on families and children and they tend to be interlinked.
Priority areas identified
The first of these factors is maternal depression, a problem which is largely neglected in antenatal advice and care despite being experienced by one in eight new mothers. The second is domestic violence which is estimated to affect one in 16 children in the UK and is one of the most common causes of mental health problems in women. The third is parental alcohol misuse, a problem which affects one in 11 children and disproportionately accounts for behavioural, educational and emotional difficulties in children than those whose parents have other mental or physical health problems. Crash Barriers argues that by intervening early to help families to overcome problems associated with these key risk factors it will create a sound basis for early intervention support and will bring about far reaching benefits to families, society and the tax payer.
As well as identifying priority risk factors in helping more families to overcome their problems, Crash Barriers also highlights the need for all professionals to take a holistic view of a family's needs rather than catering for a struggling parent or a child with behavioural difficulties. As Eileen Munro's review of social work points out, professionals often focus narrowly on assessing and quantifying risks rather than thinking more broadly about solutions which can benefit the entire family8. Given the prevalence of alcohol misuse in the UK, it is worrying to note that fewer than 60 projects support both children and parents affected by alcohol abuse. This indicates that the majority are still not properly engaging with the wider needs of the family, to the detriment of all.
Children's Centres play a vital role
While the majority of local authorities have a huge challenge ahead in terms of making preventativefamily support a reality, the good news is that communities have a solid platform from which to develop these programmes, as more than 3,500 Children's Centres across the country provide a vital building block. The respected and trusted relationship that many parents have already developed with Children's Centres makes them the ideal locations from which to implement early intervention and preventative family support programmes.
We believe that Children's Centres should now be extended to become "Children and Family Centres" which could help vulnerable families develop long-term coping mechanisms to prevent crises. In some areas, midwives, health visitors and outreach workers are already working effectively together onsite at the centres, helping to create seamless links between relevant agencies and support services. Many of them report that linking with the centres helps them to increase their reach and engagement with vulnerable families. The majority of Children's Centres already offer parenting support, with some working in partnership with specialist organisations which offer targeted services.
As government sets out to recruit an additional 4,200 health visitors to promote public health in communities, we eagerly await more detail on how they will work in partnership with Children's Centres to make early intervention a reality. We will be putting pressure on local and central government to take heed of the plethora of evidence highlighted in recent reports from Graham Allen MP and Franks Field MP, who all agree that preventative programmes are an urgent priority and that children's centres should be placed at the heart of their delivery. Through our Give me Strength campaign we are hoping to tap into the wealth of support we know is out there to make this happen.
Further information To find out more about the Give me Strength campaign, visit www.givemestrength.org.uk
Here are some key ways you can help:
_ Encourage your local authority health authority to prioritise early intervention support programmes and work in close partnership with Children's Centres who already have excellent links and relationships with vulnerable families
_ Sign up as a campaign supporter and email your MP or Council Leader from our website
_ Follow us on twitter - #givemestrength
_ Support us on Facebook and tell your friends - search for 4Children's Facebook group
_ Donate to 4Children to allow us to Give Strength to more families through our work in local communities. 4Childrenwww.4Children.org.uk
1. Family Commission Inquiry (February 2000-October 2010). 4Children http://www.thefamilycommission.org.uk [Accessed June 2011]
2. Children in Care in England: Statistics.House of Commons Library. 2011
3. Give me Strength campaign survey (carried out by Consumer Analysis Limited) for 4Children (April 2011). Representative sample of 2,006 adults from England, Scotland, Wales and Northern Ireland
4. Give me Strength (May 2011). 4Children http://www.givemestrength.org.uk [Accessed June 2011]
5. Early Intervention for Families with Multiple Problems. Families at Risk Division. Department for Education (DfE). 2010
6. Children in Care in England: Statistics.House of Commons Library. 2011
7. Crash Barriers (May 2011). 4 Children http://givemestrength.org.uk/wp-content/uploads/2011/05/GMS_CrashBarriers.pdf [Accessed June 2011]
8. Munro E. Interim Report: The Child's Journey,Department for Education (DfE). 2011; p12 http://www.education.gov.uk/munroreview/downloads/Munrointerimreport.pdf [Accessed June 2011]
Anne Longfield OBEChief Executive of 4Children