It's hard to remember a time when the child protection system wasn't in the spotlight. In South Australia we have had two Royal Commissions in the past three years along with the ongoing National Royal Commission into Institutional Responses to Child Sexual Abuse. Other jurisdictions too have been embroiled in cases where child protection systems have let kids, parents and the broader community down. But with numerous Royal Commissions, Coronial Inquests and Independent Reports one would be forgiven for thinking that we might not be asking the right questions. In Adelaide, Uni SA's Australian Centre for Child Protection has been looking at the bricks and mortar of the system with a view to redesigning the way we engage with families both in, and on the periphery, of the system.
Blair Boyer writes for Challenge Magazine.
It's easy to lay all the blame for this inability to 'fix' child protection at the feet of governments. I don't for a second suggest they should be absolved of blame; however when unlimited dollars and time are given to eminent experts to examine systems and make recommendations - it only follows that we have not put our finger on the questions that need to be asked if we are yet to find a solution.
Professors Fiona Arney and Leah Bromfield from The University of South
Australia's Australian Centre for Child Protection have done a lot of
research into the foundations of Australia's current child protection systems. They argue that these systems are based on 1960s knowledge and 1950s family structures and that those underlying assumptions have not changed with society over the interceding 60 years. The ground-breaking 1962 paper by Dr Henry Kempe ‘The Battered Child Syndrome’ paved the way for our current system. It was a nuanced piece of work, but what grabbed public attention was responding to the broken bones and criminal parental acts component rather than the emotional neglect and psychological harm that actually drive the bulk of notifications to child protection systems.
So, what are the practical implications of retaining a child protection system based on outdated notions?
What we know is that child protection systems worldwide are at capacity; and the hundreds of recommendations that have flowed from those Commissions, Inquiries and Independent Reports have almost always focussed on changing caseloads or broadening/altering the geographic reach of services. Whilst this is important, it ignores the underlying issues.
Put bluntly, the growth in child protection reports is unsustainable. Governments everywhere are scrambling to meet demand, regularly being caught short when resources don't enable an intervention. This also provides plentiful ammunition for Opposition parties wishing to characterise the system as broken. All one needs to do is find a case that was closed and a later incident where a child is harmed. Add into the mix an understandably frustrated parent, carer or child protection worker willing to speak to the media and you quite quickly have calls for another inquiry.
And this is where changing community expectations come in. Attitudes towards child protection have shifted drastically in the past thirty years. Along with issues like domestic violence that were once discussed only behind closed doors, child protection has been dragged out into the street and thrust into the sun's full glare. I want to be very clear that I think this is a wonderful thing; without a culture of broad community concern for the wellbeing of children our child protection systems are worthless.
But what Arney and Bromfield point out is that the fundamental workforce design of those systems has not changed to account for this shift. They have not been re-designed to account for the increase in reports or recalibrated to ensure there is capacity in the system to focus on early intervention - not just incident response.
If one looks at the growth in notifications over the past decade, it's clear that trying to respond to all of them is unrealistic. We must instead turn our minds to reducing demand by stemming the flow of kids entering the system. This is especially true when one accepts that the outcomes for kids who do enter the system are generally poor - or at the very least, not as good as they would be if they stayed in a functioning, family environment.
So, how can this reduction be achieved without vulnerable children falling through the cracks?
Arney and Bromfield tell us that about 10% of the population is responsible for 70% of the notifications and more often than not the children in that cohort present to child protection systems in the first year of their lives. The total cost of those notifications by age 12 is between $20,290 and $52,245 per child - regardless of whether the notifications have been substantiated (keeping in mind that substantiations in South Australia for the 2014/15 year ran at roughly 10%). These figures show that because we are not addressing the prolific dysfunction of some families, the system's resources are being drained trying to service that relatively small cohort. We must find a way to resolve those cases satisfactorily for both the good of the child and to free the system up to respond to more notifications and focus on early intervention.
If one were to compare the approaches of the health care and child protection systems it could be said that the notion of preventative health care has lodged in the public consciousness in a way that preventative child protection is yet to do. The concept of preventative health has been drummed into us for decades with powerful, memorable advertising campaigns dealing with illnesses like lung cancer, heart disease and obesity. Not so child protection.
Can you picture the TV commercial? A squalid house, dishevelled child, strung out parent(s) yelling, hitting, neglecting - fast forward 15 years and the child is a damaged, unhappy adult, possibly incarcerated or perpetrating the same crimes on another generation. But where the instruction at the climax of the QUIT commercial is clear and easy to understand ("smoking causes lung cancer," "every cigarette is doing you damage"), what would the message be at the finale of this ad? "Don't abuse your kids"? That message is, of course, incontestable, but the messages we need to communicate around child protection are more complex than those we need to communicate to convince people to stop smoking. For example, the skill set needed to stop smoking is
roughly this: acknowledgement that it is bad for your health, some strategies for quitting and the willpower to do so. But to be a good parent, the required
skills go beyond knowing what not to do. In addition to the more obvious needs like food and shelter, children need to be nurtured, stimulated and attention must be paid to their emotional and developmental needs.
And if those needs aren't being met, it's vital that intervention occurs early while there is still realistic hope that the family can become a healthy, functioning environment for the child. After all, that is the best outcome; above all else. Simultaneously we need to do more to support and attract foster carers, however this does not address the flow of children into the system. Nor is this growth addressed by only employing additional social workers so we can respond to each and every notification.
The growth in notifications and children entering the child protection system can only be addressed by changing the way we interact with the families with whom we come into contact.
So, the challenge we face is this: what supports do we need to offer those families that account for the bulk of child protection notifications to ensure they are not continually walking the most resource intensive line of all - the line between keeping custody of their children or losing them to short or long term guardianship of the minister.
Arney and Bromfield are advocates for a multi-disciplinary response; teams of experts including: child protection, police, adult and child/infant mental health and parental alcohol and drug misuse. Government already offers these services but they are not deployed centrally from the agency responsible for child protection, nor do they work as a singular unit focused on the individual child or family. The services tend to operate in silos and the families in that
10/70 cohort are notoriously 'service resistant', a characteristic only exacerbated by more government-types coming to their door to introduce themselves. If a single, multi-disciplinary team could be deployed in response to a child protection notification – and if that team could wrap itself around the family in a way that got them to engage meaningfully – the chances of a successful outcome for the child would increase drastically. Currently, the response from child protection agencies remains social worker based. I would never criticise the work of social workers - it takes a special person to work in a field that regularly shows you the worst of humanity, but they are just one piece of the puzzle.
This would be a substantial shift from the current mono-disciplinary response and it would be more expensive – initially. But if those intensive family supports were able to arrest a slide into the child protection system the savings would be immense. And, more importantly, the outcome for the child would be improved.
But this path is not an easy one. I have used the preventative health care analogy for two reasons; first, because it highlights the relative complexity of the message we are trying to communicate and second, because our failure to inculcate in the public an understanding of why fundamental change is required means governments are likely to face resistance. Especially if that change were to mean a redistribution of child protection funding from incident response to early intervention.
And herein lies the genius of those QUIT commercials. Aside from the benefit to the individual and the long term saving to the health care system, they also warmed the public up to the need for change. They built a groundswell of support for a change in government spending. But our failure to come to the realisation that fundamental change is needed in child protection, and the impossibility of selling that message in a thirty second commercial, has left us listing, waiting for another Report to finally put its finger on the underlying
What we are left with is a system that can't raise its head above water long enough to see its way to stopping the flood. And as long as the paradigm remains one of incident response - not early intervention- the number of notifications will continue to increase and so too will the number of children under guardianship.
Here in South Australia we are just months away from the final Report of the Child Protection Systems Royal Commission. For the first time this is a true 'roots and branch' review. Royal Commissioner the Hon Margaret Nyland AM has gone to great lengths to speak to stakeholders and there is much positivity around her work to date from a sector historically sceptical of more recommendations for change.
The challenges facing the child protection system in South Australia are not unique. But if this Royal Commission Report addresses how we engage with that 10% of the population responsible for 70% of child protection notifications, the broader system will generate its own capacity to both respond to more notifications and refocus its attention on early intervention rather than crisis response.