Accountability in the out of home care sector
Is a child who leaves out-of-home care in 2019 any better off than those that left 20, 30 or 50 years ago? There are two answers to this question: probably not and we don’t know.
Let’s look at each answer.
Predicting the path of any child who goes through the out-of-home care sector is difficult. However the statistics speak for themselves: children and young people continue to be overrepresented in poor mental health, street prostitution, drug and alcohol abuse, family violence, criminal activity, unemployment and the list goes on. These statistics show us that the out-of-home care sector is still failing our children and young people.
We don’t know
Some of the larger institutions in this sector throughout Australia have been servicing children for over 100 years each (cumulatively over 2000 years) and doing exceptional work. However, at various times when I put this question to a number of them directly or in forums, they couldn’t tell me whether a child is better off now than in the past. The Centre of Excellence in Child and Family Welfare in Victoria, again servicing children for over 100 years could not tell me, nor a past Minister responsible for children in care, although they did say, “I’d like to be optimistic”.
When I put it to myself, I can’t answer categorically but I fear from what I see around me the answer is no.
Both these answers seem to me to be a catastrophic failure on the sector’s part. If this were to happen in any other health sector the community would be up in arms, but it is not.
Why not? Because the sector is not tracking outcomes, so it’s not held accountable.
Everyone across the board — from government to agencies to individual workers — acknowledges that we need better outcomes for kids. But individual efforts of the many passionate and committed people who work in the out-of-home care sector is not enough. It must be supported by a commitment to tracking outcomes at government and organisational level.
Why is tracking outcomes so important?
Tracking outcomes works on two levels.
On the day-to-day level for the child in care it informs the people around the child whether the intervention is having a positive impact or not, which helps them plan and adjust the intervention as needed. It’s the equivalent of taking the vital signs of a child in hospital and adjusting treatment if required.
On a sector level it helps us understand our work and how to improve it. Rather than looking overseas for the latest best practice, evidence-based solution, which come and go like the flavour of the month, the sector could be learning from its own practice. It could be benefitting from the excellent work done by the many talented individuals who support vulnerable children and young people, by tracking the outcomes of their work. It is noted that the Victorian Centre of Excellence in Chid and Family Welfare’s “Outcomes Practice Evidence Network” is a move to address this issue.
It also means the sector can be held accountable for where children end up. And I believe that’s the nub of the problem.
Who’s protecting who?
About three years ago I developed some technology to track the outcomes of children in our sector. When I presented it to executives at the Department of Health and Human Services, one of their question surprised me:
‘How do you think agencies will feel?’
‘What do you mean?’ I responded.
‘They will be accountable,’ was the answer.
It had never crossed my mind that organisations in this field would fear accountability, but then again there was the Royal Commission into Institutional Responses to Sexual Abuse. One of their major findings was that institutions had a propensity to protect themselves and their reputations before protecting children.
About three years ago, in the middle of the Royal Commission, I was a witness before a senate enquiry into out-of-home care. I stated my thoughts about the sector and presented some deidentified photos of residential houses so that senators could see the living arrangements of some traumatised children. In response a number of CEOs of some of the largest institutions in Victoria banded together to boycott Australian Childhood Trauma Group, because we dared to, ‘speak out of school’. A worker from one organisation called to ask for a refund to a training that we were conducting. They had sponsored one of their carers to attend but wanted to resend that support.
How can this be right?
Here in lies the problem with our sector, people are fearful to speak out because of the potential consequences.
Australia has a poor history when it comes to supporting whistle blowers. Our sector needs to be far more transparent, document and track individual outcomes of our clients and make this data available to the greater community to see without any smoke or mirrors. Only then do I think we will see a monumental shift in the mental health and wellbeing of children and young people in our care.
Our sector needs to be held accountable for where children end up.
Founder / CEO
Australian Childhood Trauma Group