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'It's not the State's problem, it's the family's': Care system to adopt tough love approach

The chief executive of Tusla said the agency wants families to share more power and responsibility, and to “own their problems”.

THE CHILD AND Family Agency is adopting a new approach to dealing with families that involves asking them to “own their problem”, the agency’s chief executive has said.

In a wide-ranging interview with TheJournal.ie this week, Fred McBride, who took on his role earlier this year, said Tusla wants to move more towards “sharing power and control and responsibility with children and families and communities, rather than the traditional rather paternalistic public service approach, which was very much doing things to people and for people”.

Of course the State’s got to provide some kind of safety net, but we can’t allow people to get entangled in it.

“Certainly part of my approach is getting families to own the problem, because unless they own the problem we’re not going to be able to work with them to move it on, and of course if they don’t own the problem then the State’s intervention increases accordingly,” he said.

McBride stressed this is not about the State refusing to take children in care or failing to intervene robustly where necessary, rather it is about trying to pitch interventions at the right level.

We do want to challenge families more, we want to demand a bit more from families to have aspirations and, as I say, to take ownership of the problem. It’s not the State’s problem, it’s the family’s problem, but our job is to try to support them to come up with solutions to their problem.

Working together

McBride said this progressive approach to dealing with vulnerable children and families can only work with the cooperation of other state agencies. However budget constraints can “push people to guard their own budget and start to build barriers” he said.

Perhaps there’s also a degree of professional preciousness or snobbery that prevents people from really valuing the contributions of other professionals.

The problem, according to McBride, is predominantly a strategic one, and something that needs to be tackled at top management level.

“I think there’s some good joint working happening at the frontline out in the localities.”

Almost as if it happens because of good local relationships rather than as a result of a government or senior management mandate, and that mandate is really important, that needs to be given much more strongly.

Many children in care are faced with upsetting situations in their everyday lives and are in need of supports outside of the agency’s remit like mental health services.

When asked whether delays for children accessing mental health services impeded his organisation’s work, McBride was frank in his answer.

Yes it can. And you know many reports – the National Child Review Panel, the child deaths [report], frequent reports – note that a lack of an appropriate and timely mental health service has been a contributory factor in some of those deaths, particularly the suicides.

One barrier to supports is that many of these young people are not clinically mentally ill, he said. “Emotionally they’re not well, so it’s not necessarily a pure or clinical psychiatric approach that’s needed, it’s more a therapeutic approach”.

“They need help, but if they don’t have a clinical diagnosis of mental illness, then the question is: What other type of help is there and who’s best placed to deliver that? That can be challenging.”

He noted that he knows colleagues in the HSE want to expand services for young people and Tusla is “very willing” to contribute staff to create a multi-disciplinary approach.

And also we’re trying to create some in-house Tusla therapeutic services, again multidisciplinary, with different types of therapies available – play therapy, art therapy, music therapy, psychotherapy, all the different types of services that can be brought to bear when a child is not technically clinically mentally ill but they’re emotionally damaged or suffering in some way.

Social workers

One major criticism of the care system in recent years has centred on high numbers of children waiting for a social worker to be allocated to their case.

Back in 2014, when Tusla was first established, there were 8,685 children waiting for a social worker to take on their case. As of August this year, that number has been brought down to 4,727.

“That’s a near 50% reduction in two years. That’s good performance, whichever industry standard you might want to apply,” Mc Bride commented. “Now, it’s still 4,000 too many, but we have to look at that in the context of having 44,000 referrals a year.”

“Since Tulsa was created, we’ve had a near 80% reduction in unallocated cases that were categorised as high priority.”

Though there has been a vast improvement in the short life of the new agency, McBride conceded that the delays can make “a big difference” in some cases.

Their problems are potentially getting worse and then we’re left to intervene in more of a crisis situation rather than at an earlier stage.

However, he stressed that, while these families are waiting, “they’re not being ignored”.

Their cases are reviewed on a weekly basis, with visits if necessary and input from schools.

Whilst it’s not ideal, and you may get different social workers calling, that’s not ideal, and I’m not trying to say that it’s okay – it’s not – I’m just making the point that they’re not ignored. They’re kept under monitor and review in the event that should matters deteriorate or escalate, then an appropriate and proportionate response is given.

Missing

Finding the right solution for children who have to be taken from their parents is a tough task for the agency and in some cases the young person – particularly teenagers – will be resistant to the change in their life and leave their foster home or residential care unit.

“Often actually they’re not missing – we know where they are, they’re just not where they’re meant to be,” McBride explained.

“They’ll be at home with families or they’ll be with a friend and we know that, but sometimes trying to get a hold of them can be a bit trickier. If teenagers want to kind of evade adults they’ll find a way of doing it.”

I think we need to be careful to separate out normal teenage behaviour – that coming home late kind of thing, or staying with a friend – from children whose general circumstances would place them at more significant risk should they go missing. And that’s what we’re trying to do.

McBride said gardaí sometimes get “frustrated” with staff frequently reporting young people – sometimes the same young people multiple times – missing.

Sometimes, when it’s not in their interest to be with their family, on occasions, they’re being harboured by their families – not illegally – but outside of their agreed plan.

Childcare

McBride also spoke about the recent announcement that, from next year, the government will offer a tax rebate for childcare – either with a childminder or a creche. However, this new scheme came under scrutiny in the last couple of weeks after it was revealed there are only 119 childminders registered with Tusla – and you have to use either a childminder or creche registered with the agency to benefit from it.

Some counties do not have any childminders registered with the agency, as a person has  to take care of four or more children to do so.

“In neighbouring jurisdictions, in the UK, you’ve got to register for any number of children and I thought that was a safer and more appropriate thing to do,” McBride said.

“We’re responsible for the regulation and registration of early years service – creches and childminders, of course. As part of that, and we inspect them, but I think there needs to be much more of a focus on qualitative registration and inspection rather than that they meet basic minimum requirements.”

McBride said this country has yet to see a “coherent cross-government early years strategy”, stressing he will need to take some responsibility for moving that along.

“That strategy is not just about providing childcare, as important as that is, it is also about family support and parenting support and how we help children to develop these positive attachments early on in their lives and that’s a key bit for us.”

Read: ‘Some flee immediately’: Migrants pretending to be children to get into Ireland>

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