Child protection overhaul – subterfuge or the real answer?

Our sector has been regularly calling for an overhaul of the Victorian child protection system and greater investment in early intervention for at least 30 years. The most recent call is in a  report commissioned by Berry Street: ‘The economic case for early intervention in the child protection and out-of-home care system in Victoria’.

According to this report an average of 11 children a day are currently coming into out-of-home care in Victoria. That’s more than 4000 a year. The report quite rightly identifies the need for targeted long-term investment in early intervention to help reduce these numbers. But does focussing on funding and numbers get to the core of the problem?

In a Herald Sun article called “How changes to child protection could save lives”,  Grant McArthur discusses the Berry Street report and refers to a recent overhaul of the NSW child protection system:

 “Faced with a similar situation NSW overhauled its system in recent years to focus on intervening in troubled families sooner, cutting the number who needed to be removed from home from 4000 to 2000 a year.”

Of course this looks like great news on the face of it, but it begs the question: does stopping children coming into care address the core of the problem? How do we know if the outcomes are better for those 2000 NSW children who didn’t go into care?

The system we have is so clunky and our data is so unrefined that the only ‘measure’ we have for outcomes is whether or not a child goes into care, with the assumption that the child who doesn’t go into care will be better off.  But is this so? How do we know if the child that is diverted from care is receiving the right interventions?

To fix a problem we first need to understand it.

Unlike medical care, the child protection system does not do triage well. In medicine, triage means assigning degrees of urgency to wounds or illnesses to decide the order of treatment of patients. In child protection this could be translated as assessing the developmental stages of children at their point of entry to the system to determine their physical, cognitive and social/emotional needs. In  other words, the ‘wounds or illnesses’ are the child’s adverse experiences, and ‘the order of treatment’ equates to targeted interventions to meet the child’s developmental needs. Triaging a child’s needs and development in this way gives the child (and family) the best possible chance to reach their potential.

We know how children develop, what milestones children should reach, when and how they will manage big feelings and so forth. Early intervention programs that do not holistically assess the physical, cognitive and social/emotional developmental stages of their ‘clients’ in real time have less ability to assess whether their intervention is having a positive impact.

This risks failing the child and the family.

If those 2000 NSW children who did not go into care are not reaching important physical, cognitive and social/emotional developmental milestones, if they doing no better psychologically and physically than children that do go into care, then what is achieved beyond a feel-good statistic?

Setting a benchmark that simply says, ‘Let’s have fewer children in care’ is not enough. The benchmark should be, ‘Let’s have fewer children in care and let’s assess them against national developmental milestone standards and create interventions that ensure this cohort of vulnerable children will be no worse off than less vulnerable children.’

In this way we will truly have a system to be proud of. One that can address the needs of each vulnerable child help them escape being on the ‘at risk’ list as they move through their life.

What are the solutions?

In our current case management approach to care, a case worker determines the needs of the child or family, then tries to meet these needs in a fragmented system of different service providers. This doesn’t seem a productive way to go about caring for vulnerable children. It’s akin to the child being sent to one hospital for an x-ray, another for their diagnoses and still another for treatment.

Surely a better way to proceed is to firstly provide ‘triage’ for families to assess everybody’s needs, and this includes needs for their physical, cognitive and social/emotional wellbeing.

This could be provided through ‘holistic’ health centres with outreach components within local government catchment areas, which are set up in partnership with specialist service providers, such as primary health networks, Headspace and CAMHs style services.

These health hubs could provide families with connections to medical, psychological and allied health specialist support. This would not only stem the number of children going into care but also ensure the specialist supports are available to help children meet their potential.

The Victorian Government provides something akin to this through their School Readiness Funds Program, (although this does not have the flexibility that some would like). The program provides a range of holistic specialist support services to children in kindergarten and their families. This is a good start, but we need to get more services coordinated at a local government level, which is much closer to the action and state or federal departments.

We currently work in silos across government departments and community and private support services. For vulnerable people this makes it hit and miss as to whether they get the service they need. We have the parts of the system, but these are so often fragmented, hard to find, impossible to co-ordinate, or cost-prohibitive that clients can wait extraordinary long periods of time for services and often the damage is done, making recovery so much more difficult.

So, before we overhaul anything let’s see if in fact we have the right pieces of the puzzle. It may be we have what we need it’s just that we don’t know how to bring it all together.

Gregory Nicolau

Founder / CEO

Australian Childhood Trauma Group